| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CAMERON M. HARRIS AND COMPANY3 Filed as: CAMERON M. HARRIS & CO., LLC | 6400 FAIRVIEW RD CHARLOTTE, NC 282103237 | PRINCIPAL LIFE INSURANCE COMPANY | $61K | $5K | $66K | 10.82% |
| CORESOURCE, INC.3 Filed as: CORESOURCE | 655 METRO PL S STE 700 DUBLIN, OH 430173661 | VISION SERVICE PLAN | $40K | — | $40K | 9.96% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CORESOURCE, INC. EIN 35-1846036 BENEFIT ADMINISTRATOR | Plan Administrator; Claims processing; Other services Service code 12 | — | $2.0M |
| AETNA - PPO EIN 06-6033492 NONE | Claims processing; Other services Service code 12 | — | $753K |
| MEDCOST EIN 56-1999192 NONE | Claims processing Service code 12 | — | $91K |
| ACS EIN 36-4129784 NONE | Claims processing; Other services Service code 12 | — | $66K |
| MULTIPLAN EIN 43-6004435 NONE | Other services; Plan Administrator; Claims processing Service code 12 | — | $64K |
| SOVOS COMPLIANCE, LLC NONE | Other services; Other fees Service code 49 | 200 BALLARDVALE ST WILMINGTON, MA 01887 | $36K |
| DIXON HUGHES GOODMAN LLP EIN 56-0747981 ACCOUNTANT | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $22K |
| EMPLOYEE BENEFITS CORP EIN 39-2044064 NONE | Other services Service code 49 | — | $9K |
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 | 8,086 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 44 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 8,130 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | KAISER FOUNDATION HEALTH PLAN, INC. | 737 | $5.1M |
| Vision | VISION SERVICE PLAN | 3,633 | $406K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 8,086 | $610K |
| Stop-loss / reinsurancereinsurance | AETNA LIFE INSURANCE CO. | 2,872 | $641K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 8,086 | — |
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.