| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACS BENEFIT SERVICES LLC3 | 470 W. HANES MILL ROAD STE 100 WINSTON SALEM, NC 27105 | COMPANION LIFE INSURANCE COMPANY DBA IISI | $11K | — | $11K | 10.00% |
| EBENCONCEPTS COMPANY3 Filed as: EBENCONCEPTS COMPAY | 3150 N ELM STE 201 GREENSBORO, NC 27408 | STARMOUNT LIFE INSURANCE COMPANY | $1K | $246 | $2K | 13.99% |
| DENNIS INSURANCE3 Filed as: DENNIS INSURANCE & FINANCIAL SERVI | 901 BATTLEGROUND AVE STE A GREENSBORO, NC 27408 | USABLE LIFE | $207 | — | $207 | 6.54% |
| MOSAIC GROUP SERVICES3 | PO BOX 2291 DURHAM, NC 27702 | USABLE LIFE | $143 | — | $143 | 4.52% |
| EBENCONCEPTS COMPANY3 | 3150 NORTH ELM STE 201 GREENSBORO, NC 27408 | USABLE LIFE | $80 | — | $80 | 2.53% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ACS BENEFIT SERVICES, LLC EIN 56-1472467 CLAIMS ADMINISTRATOR | Contract Administrator; Claims processing Service code 12 | — | $68K |
| VOLTAIRE HEALTH, LLC DBA PAYER COMP EIN 46-2047081 OTHER SERVICE PROVIDER | Other services Service code 49 | — | $31K |
| USABLE LIFE EIN 71-0505232 ADMINISTRATOR | Insurance services Service code 23 | — | $3K |
| AMERICAN HEALTH HOLDING INC. EIN 31-1368946 INSURANCE SERVICES | Insurance services Service code 23 | — | $2K |
| SELF FUNDING ACTUARIAL SERVICES EIN 56-1472476 ACTUARIAL | Actuarial Service code 11 | — | $600 |
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 | 184 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 184 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COMPANION LIFE INSURANCE COMPANY DBA IISI | 184 | $106K |
| Vision | STARMOUNT LIFE INSURANCE COMPANY | 144 | $12K |
| Life insurance(2 contracts, 2 carriers) | COMPANION LIFE INSURANCE COMPANY DBA IISI | 184 | $109K |
| Stop-loss / reinsurancereinsurance | COMPANION LIFE INSURANCE COMPANY DBA IISI | 184 | $106K |
| Other(2 contracts, 2 carriers) | COMPANION LIFE INSURANCE COMPANY DBA IISI | 184 | $109K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 184 | — |
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.