| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CAMERON M. HARRIS AND COMPANY3 Filed as: CAMERON M HARRIS & COMPANY LLC | PO BOX 220948 CHARLOTTE, NC 28222 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $42K | $2K | $44K | 16.19% |
| CAMERON M. HARRIS AND COMPANY3 Filed as: CAMERON M HARRIS & CO LLC | PO BOX 220948 CHARLOTTE, NC 28222 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $36K | $3K | $39K | 19.72% |
| CAMERON M. HARRIS AND COMPANY3 Filed as: CAMERON M HARRIS & CO LLC | PO BOX 220948 CHARLOTTE, NC 28222 | AMERITAS LIFE INSURANCE CORP. | $13K | — | $13K | 10.04% |
| IBSI HOLDINGS INC3 | 3330 HEALY DRIVE WINSTON-SALEM, NC 27103 | AMERITAS LIFE INSURANCE CORP. | $7K | — | $7K | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTHGRAM EIN 56-1449504 NONE | Plan Administrator Service code 14 | — | $210K |
| CIGNA EIN 59-1031071 NONE | Contract Administrator Service code 13 | — | $127K |
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 | 794 | 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) | 794 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | AMERITAS LIFE INSURANCE CORP. | 1,573 | $133K |
| Vision | VISION SERVICE PLAN | 658 | $68K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,637 | $470K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,637 | $271K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,637 | $271K |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,637 | $470K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,637 | — |
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.