| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DAVID SIMAS3 Filed as: DAVID D. SIMAS | 6100 FAIRVIEW ROAD, 1000 CHARLOTTE, NC 28210 | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | $27K | — | $27K | 2.35% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | PO BOX 203510 DALLAS, TX 75320 | HUMANA INSURANCE COMPANY | $8K | — | $8K | 9.95% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 6100 FAIRVIEW ROAD, SUITE 1400 CHARLOTTE, NC 28210 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | — | $3K | 10.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 1018 WEST 9TH AVENUE KING OF PRUSSIA, PA 19406 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $437 | $3K | 12.73% |
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 | 101 | 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) | 101 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 272 | $1.2M |
| Dental | HUMANA INSURANCE COMPANY | 101 | $75K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 299 | $21K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 96 | $30K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 272 | $1.2M |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 299 | $21K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 299 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.