| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MOUNTCASTLE INSURANCE3 | 307 WEST CENTER ST LEXINGTON, NC 27292 | CIGNA HEALTH & LIFE INSURANCE COMPANY | $16K | — | $16K | 2.41% |
| IBSI HOLDINGS INC3 Filed as: IBSI HOLDINGS | PO BOX 24337 WINSTON SALEM, NC 27114 | CIGNA HEALTH & LIFE INSURANCE COMPANY | $5K | — | $5K | 0.72% |
| GW MOUNTCASTLE AGENCY INC.3 Filed as: GW MOUNTCASTLE AGENCY INC | 307 WEST CENTER ST LEXINGTON, NC 27292 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $18K | — | $18K | 15.00% |
| IBSI HOLDINGS INC3 Filed as: IBSI HOLIDINGS INC | PO BOX 24337 WINSTON SALEM, NC 271144337 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $6K | $6K | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH & LIFE INSURANCE COMPA EIN 59-1031071 THIRD PARTY ADMINISTRATOR | Non-monetary compensation; Direct payment from the plan; Distribution (12b-1) fees; Named fiduciary; Participant communication; Contract Administrator; Other services; Claims processing Service code 12 | — | $98K |
| MOUNTCASTLE INSURANCE CONSULTANT | Consulting (general); Other fees Service code 16 | 307 WEST CENTER ST LEXINGTON, NC 27292 | $52K |
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 | 275 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 275 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH & LIFE INSURANCE COMPANY | 228 | $670K |
| Vision | CIGNA HEALTH & LIFE INSURANCE COMPANY | 228 | $670K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 275 | $123K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 275 | $123K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH & LIFE INSURANCE COMPANY | 228 | $670K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 275 | $123K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 275 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.