| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DALE K. MOORE3 | PO BOX 220748 CHARLOTTE, NC 28222 | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | $20K | $0 | $20K | 1.66% |
| USI INSURANCE SERVICES LLC3 | 8049 CORPORATE CENTER DRIVE CHARLOTTE, NC 28226 | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | $15K | $0 | $15K | 1.24% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 6100 FAIRVIEW ROAD, SUITE 1400 CHARLOTTE, NC 28210 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | $27 | $6K | 4.08% |
| USI INSURANCE SERVICES LLC3 | 8049 CORPORATE CENTER DRIVE CHARLOTTE, NC 28226 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | $27 | $5K | 3.67% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | PO BOX 203510 IRVING, TX 75063 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $27 | $2K | 1.54% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 1018 WEST 9TH AVENUE KING OF PRUSSIA, PA 19406 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $1K | $1K | 0.73% |
| USI INSURANCE SERVICES LLC3 | PO BOX 61007 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $933 | $933 | 0.64% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | PO BOX 203491 DALLAS, TX 75320 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $3K | $0 | $3K | 17.79% |
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 | 170 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 3 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 174 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 285 | $1.2M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 284 | $145K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 284 | $145K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 284 | $145K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 284 | $145K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 285 | $1.2M |
| Other(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 284 | $170K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 285 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.