| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 4819 EMPEROR BLVD. STE. 200 DURHAM, NC 27703 | PRINCIPAL LIFE INSURANCE COMPANY | $6K | $1K | $7K | 10.66% |
| MOSAIC GROUP SERVICES3 Filed as: MOSAIC GROUP SERVICES LLC | PO BOX 2291 DURHAM, NC 27702 | PRINCIPAL LIFE INSURANCE COMPANY | $3K | $122 | $3K | 4.49% |
| HCW EMPLOYEE BENEFIT SERVICES, LLC3 Filed as: HCW EMPLOYEE BENEFIT SERVICES LLC | 4819 EMPEROR BLVD. STE 200 DURHAM, NC 27703 | PRINCIPAL LIFE INSURANCE COMPANY | $1K | — | $1K | 1.59% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 2850 GOLF RD FL 11 ROLLING MDWS, IL 60008 | PRINCIPAL LIFE INSURANCE COMPANY | — | $206 | $206 | 0.32% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | PO BOX 939 BURLINGTON, NC 27216 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $796 | $2K | $2K | 10.43% |
| N WESTERN GP MRKG SERV OF E NC INC3 | 4020 WESTERN BLVD. FL 2 RALEIGH, NC 27607 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 6.55% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | PO BOX 939 BURLINGTON, NC 27216 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $726 | $1K | $2K | 10.52% |
| N WESTERN GP MRKG SERV OF E NC INC3 | 4020 WESTCHASE BLVD FL 2 RALEIGH, NC 27607 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 6.57% |
No Schedule C service providers reported on this filing.
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 133 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 134 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 204 | $64K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 204 | $64K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 204 | $64K |
| Long-term disability(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 118 | $44K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 204 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.