| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DENNIS INSURANCE3 | 901 BATTLEGROUND AVE STE A GREENSBORO, NC 27408 | CIGNA HEALTH AND LIFE INSURANCE CO | $25K | — | $25K | 6.00% |
| DENNIS INSURANCE3 | 901 BATTLEGROUND SUITE A GREENSBORO, NC 27408 | SYMETRA LIFE | $23K | $9K | $32K | 17.15% |
| MOSAIC GROUP SERVICES3 Filed as: MOSAIC GROUP SERVICES LLC | 4615 UNIVERSITY DR DURHAM, NC 27707 | SYMETRA LIFE | $12K | — | $12K | 6.25% |
| DENNIS INSURANCE3 | 901 BATTLEGROUND AVE STE A GREENSBORO, NC 27408 | SYMETRA LIFE | $4K | $2K | $6K | 14.81% |
| MOSAIC GROUP SERVICES3 Filed as: MOSAIC GROUP SERVICES LLC | 4615 UNIVERSITY DR DURHAM, NC 27707 | SYMETRA LIFE | $0 | $2K | $2K | 5.00% |
| DENNIS INSURANCE3 | 901 BATTLEGROUND AVE SUITE A GREENSBORO, NC 27408 | HCC LIFE INSURANCE COMPANY | $2K | — | $2K | 6.00% |
| DENNIS INSURANCE3 | 901 BATTLEGROUND, STE A GREENSBORO, NC 27408 | GUARDIAN | $13K | — | $13K | 45.35% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INS CO EIN 59-1031071 0 | Contract Administrator; Participant communication; Named fiduciary; Claims processing; Non-monetary compensation; Direct payment from the plan; Float revenue; Other services Service code 12 | — | $68K |
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 | 266 | 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) | 266 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | GUARDIAN | 219 | $29K |
| Vision | GUARDIAN | 219 | $29K |
| Life insurance(2 contracts, 2 carriers) | SYMETRA LIFE | 219 | $216K |
| Short-term disability | SYMETRA LIFE | 217 | $187K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE CO | 266 | $425K |
| Other(4 contracts, 3 carriers) | SYMETRA LIFE | 219 | $289K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 266 | — |
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.