| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIAM W. PLYLER3 Filed as: WILLIAM PLYLER | 100 SUMMIT LAKE DRIVE, SUITE 400 VALHALLA, NY 10595 | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | $47K | — | $47K | 1.01% |
| USI INSURANCE SERVICES LLC3 | 6100 FAIRVIEW ROAD, SUITE 1400 CHARLOTTE, NC 28210 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $88K | $0 | $88K | 13.47% |
| MOSAIC GROUP SERVICES3 Filed as: MOSAIC GROUP SERVICES LLC | 4613 UNIVERSITY DRIVE DURHAM, NC 27707 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $31K | $31K | 4.71% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62819 VIRGINIA BEACH, VA 23466 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $20K | $20K | 3.06% |
| USI INSURANCE SERVICES LLC3 | 6100 FAIRVIEW ROAD, SUITE 1400 CHARLOTTE, NC 28210 | STARMOUNT LIFE INSURANCE COMPANY | $20K | $0 | $20K | 9.40% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62819 VIRGINIA BEACH, VA 23466 | STARMOUNT LIFE INSURANCE COMPANY | $2K | $7K | $9K | 4.15% |
| USI INSURANCE SERVICES LLC3 | 6100 FAIRVIEW ROAD, SUITE 1400 CHARLOTTE, NC 28210 | UNUM INSURANCE COMPANY | $18K | $0 | $18K | 14.99% |
| MOSAIC GROUP SERVICES3 Filed as: MOSAIC GROUP SERVICES LLC | 4613 UNIVERSITY DRIVE DURHAM, NC 27707 | UNUM INSURANCE COMPANY | $0 | $6K | $6K | 4.95% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62819 VIRGINIA BEACH, VA 23466 | UNUM INSURANCE COMPANY | $0 | $4K | $4K | 2.99% |
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 | 521 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 16 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 542 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 679 | $4.7M |
| Dental | STARMOUNT LIFE INSURANCE COMPANY | 538 | $217K |
| Vision | STARMOUNT LIFE INSURANCE COMPANY | 538 | $217K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,198 | $650K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,198 | $650K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,198 | $650K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 679 | $4.7M |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,198 | $770K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,198 | — |
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."
No prospect flags tripped on this filing.