| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JAMES A HARDISON V3 Filed as: JAMES HARDISON | 51 E 4TH STREET WINSTON SALEM, NC 27101 | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | $40K | — | $40K | 4.76% |
| MCGRIFF INSURANCE SERVICES INC3 | PO BOX 168 WINSTON SALEM, NC 27102 | UNION SECURITY INSURANCE COMPANY | $750 | $475 | $1K | 3.27% |
| THE BENEFIT COMPANY INC3 | PO BOX 211486 COLUMBIA, SC 29221 | UNION SECURITY INSURANCE COMPANY | — | $750 | $750 | 2.00% |
| MCGRIFF INSURANCE SERVICES INC3 | PO BOX 168 WINSTON SALEM, NC 27102 | SYMETRA LIFE INSURANCE COMPANY | $3K | — | $3K | 15.00% |
| MOSAIC GROUP SERVICES3 Filed as: MOSAIC GROUP SERVICES LLC | PO BOX 2291 DURHAM, NC 27702 | SYMETRA LIFE INSURANCE COMPANY | — | $899 | $899 | 5.03% |
| MCGRIFF INSURANCE SERVICES INC3 | 3605 GLENWOOD AVE STE 201 RALEIGH, NC 27612 | SUN LIFE ASSURANCE COMPANY OF CANADA | $2K | $294 | $3K | 15.42% |
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 | 103 | 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) | 103 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 132 | $838K |
| Dental | UNION SECURITY INSURANCE COMPANY | 70 | $37K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 107 | $18K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 132 | $838K |
| Other(2 contracts, 2 carriers) | SYMETRA LIFE INSURANCE COMPANY | 107 | $36K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 132 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.