| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BRANDON S MILLS3 | 600 SPRINGWOOD DRIVE JACKSONVILLE, NC 28546 | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | $5K | — | $5K | 5.16% |
| SIA GROUP INC3 | 827 GUM BRANCH ROAD JACKSONVILLE, NC 28540 | HARTFORD LIFE AND ACCIDENT | $12K | — | $12K | 15.17% |
| MOSAIC GROUP SERVICES3 Filed as: MOSAIC GROUP SERVICES, LLC | 4611 UNIVERSITY DRIVE DURHAM, NC 27702 | HARTFORD LIFE AND ACCIDENT | — | $5K | $5K | 6.56% |
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 | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 170 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 170 | $89K |
| Dental | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 170 | $89K |
| Vision | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 170 | $89K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 134 | $82K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 134 | $82K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 170 | $89K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 142 | $341K |
| Other(2 contracts, 2 carriers) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 170 | $171K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 170 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.