| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SCOTT C. ANDERSON3 | 432 HIGHLAND FOREST DRIVE CHARLOTTE, NC 28270 | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | $22K | $0 | $22K | 1.50% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62819 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $11K | $5K | $16K | 15.13% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62939 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $4 | $4 | 0.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62689 VIRGINIA BEACH, VA 23466 | USABLE LIFE | $14K | $2K | $16K | 17.42% |
| MOSAIC GROUP SERVICES3 | PO BOX 2291 DURHAM, NC 27702 | USABLE LIFE | $6K | $0 | $6K | 6.00% |
| USI INSURANCE SERVICES LLC3 | 4840 COX ROAD, SUITE 150 GLEN ALLEN, VA 23060 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | $0 | $1K | 11.76% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62819 VIRGINIA BEACH, VA 23466 | METLIFE LEGAL PLANS | $568 | $144 | $712 | 11.74% |
| USI INSURANCE SERVICES LLC3 | 6100 FAIRVIEW ROAD, 14TH FLOOR CHARLOTTE, NC 28210 | HARTFORD LIFE AND ACCIDENT | $255 | $37 | $292 | 17.18% |
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 | 131 | 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) | 131 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 220 | $1.5M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 224 | $106K |
| Vision | COMMUNITY EYE CARE | 163 | $25K |
| Life insurance | USABLE LIFE | 120 | $93K |
| Long-term disability | USABLE LIFE | 120 | $93K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 220 | $1.5M |
| Other(5 contracts, 5 carriers) | USABLE LIFE | 131 | $113K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 224 | — |
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.