| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EBENCONCEPTS COMPANY3 | 15305 DALLAS PARKWAY SUITE 800 ADDISON, TX 75001 | USABLE LIFE | $773 | $107 | $880 | 11.37% |
| MOSAIC GROUP SERVICES3 Filed as: MOSAIC GROUP | PO BOX 2291 DURHAM, NC 27702 | USABLE LIFE | $386 | — | $386 | 4.99% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EBENCONCEPTS COMPANY, INC. CONSULTANT | Consulting (general) Service code 16 | 639 EXECUTIVE PLACE SUITE 202 FAYETTEVILLE, NC 28305 | $46K |
| BLUE CROSS AND BLUE SHIELD OF NC EIN 56-0894904 ADMINISTRATOR | Contract Administrator; Claims processing Service code 12 | — | $36K |
| DAVIDSON HOLLAND WHITESELL & CO PLL EIN 56-1706742 AUDITOR | Accounting (including auditing) Service code 10 | — | $12K |
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 | 146 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 146 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 144 | $166K |
| Life insurance | USABLE LIFE | 146 | $8K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 144 | $166K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 144 | $166K |
| Other | USABLE LIFE | 146 | $8K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 146 | — |
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.