| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DALE K. MOORE3 Filed as: DALE K MOORE | PO BOX 220748 CHARLOTTE, NC 28222 | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | $48K | — | $48K | 4.20% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | PO BOX 203508 DALLAS, TX 75320 | HUMANA INSURANCE COMPANY | $10K | — | $10K | 9.92% |
| IBSI HOLDINGS INC3 | PO BOX 24337 WINSTON SALEM, NC 27114 | HUMANA INSURANCE COMPANY | $5K | — | $5K | 4.96% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 400 HIGHWAY 169 8TH FLOOR ST LOUIS PARK, MN 55426 | USABLE LIFE | $3K | — | $3K | 10.00% |
| MOSAIC GROUP SERVICES3 | PO BOX 2291 DURHAM, NC 27702 | USABLE LIFE | $2K | — | $2K | 5.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 400 HIGHWAY 169 SOUTH 8TH FLOOR ST LOUIS PARK, MN 55426 | USABLE LIFE | $3K | — | $3K | 10.00% |
| MOSAIC GROUP SERVICES3 | PO BOX 2291 DURHAM, NC 27702 | USABLE LIFE | $1K | — | $1K | 5.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 400 HIGHWAY 169 SOUTH 8TH FLOOR ST LOUIS PARK, MN 55426 | USABLE LIFE | $3K | $83 | $3K | 15.40% |
| MOSAIC GROUP SERVICES3 | PO BOX 2291 DURHAM, NC 27702 | USABLE LIFE | $2K | — | $2K | 10.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | PO BOX 203491 DALLAS, TX 75320 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $3K | — | $3K | 21.24% |
| JENNY AYERS3 | 522 BUTLER DRIVE HENRICO, NC 27842 | PRE-PAID LEGAL SERVICES, INC. DBA LEGAL SHIELD | $173 | — | $173 | 2.60% |
| JENNA DOYLE3 | 3665 HIGHLAND DRIVE AYDEN, NC 28513 | PRE-PAID LEGAL SERVICES, INC. DBA LEGAL SHIELD | $56 | — | $56 | 0.84% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 400 HIGHWAY 169 SOUTH 8TH FLOOR ST LOUIS PARK, MN 55426 | USABLE LIFE | $568 | — | $568 | 10.00% |
| MOSAIC GROUP SERVICES3 | PO BOX 2291 DURHAM, NC 27702 | USABLE LIFE | $284 | — | $284 | 5.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 400 HIGHWAY 169 SOUTH 8TH FLOOR ST LOUIS PARK, MN 55426 | USABLE LIFE | $467 | $29 | $496 | 15.92% |
| MOSAIC GROUP SERVICES3 | PO BOX 2291 DURHAM, NC 27702 | USABLE LIFE | $312 | — | $312 | 10.01% |
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 | 151 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 6 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 158 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 152 | $1.1M |
| Dental | HUMANA INSURANCE COMPANY | 141 | $98K |
| Vision | HUMANA INSURANCE COMPANY | 141 | $98K |
| Life insurance(2 contracts) | USABLE LIFE | 179 | $26K |
| Short-term disability | USABLE LIFE | 179 | $26K |
| Long-term disability | USABLE LIFE | 179 | $34K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 152 | $1.1M |
| Other(5 contracts, 3 carriers) | USABLE LIFE | 179 | $52K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 179 | — |
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.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.