| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MOUNTCASTLE INSURANCE3 | 307 W CENTER STREET LEXINGTON, NC 27292 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $24K | — | $24K | 9.92% |
| IBSI HOLDINGS INC3 | PO BOX 24337 WINSTON SALEM, NC 271144337 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $7K | — | $7K | 2.96% |
| MOUNTCASTLE INSURANCE3 | 307 WEST CENTER ST LEXINGTON, NC 27292 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $18K | $126 | $19K | 15.10% |
| IBSI HOLDINGS INC3 Filed as: IBSI HOLDINGS LLC | PO BOX 24337 WINSTON SALEM, NC 271144337 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $6K | $6K | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF NORTH CAR EIN 56-0894904 ADMINISTRATOR | Other fees; Claims processing Service code 12 | — | $62K |
| GW MOUNTCASTLE AGENCY INC EIN 56-6026091 CONSULTANT | Consulting fees; Consulting (general) Service code 16 | — | $36K |
| FLORES AND ASSOCIATES EIN 56-1542307 COBRA ADMINISTRATOR | Other fees; Insurance services Service code 23 | — | $2K |
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 | 312 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 312 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 285 | $237K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 285 | $237K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 312 | $123K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 312 | $123K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | 275 | $584K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 312 | $123K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 312 | — |
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.
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.