| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AXA ASSISTANCE, USA3 Filed as: BURCHFIELD INSURANCE GROUP - AXA | BURCHFIELD INSURANCE GROUP INC CONCORD, NC 28025 | MONY LIFE INSURANCE COMPANY OF AMERICA | $8K | $0 | $8K | 3.52% |
| MOSAIC GROUP SERVICES3 | MOSAIC GROUP SERVICES DURHAM, NC 27702 | MONY LIFE INSURANCE COMPANY OF AMERICA | $0 | $5K | $5K | 2.22% |
| AXA ASSISTANCE, USA3 Filed as: IBSI HOLDINGS INC - AXA | IBSI HOLDINGS WINSTON-SALEM, NC 27114 | MONY LIFE INSURANCE COMPANY OF AMERICA | $0 | $4K | $4K | 1.67% |
| BURCHFIELD INSURANCE GROUP INC3 | P O BOX 3414 CONCORD, NC 28025 | STANDARD INSURANCE COMPANY | $11K | $0 | $11K | 10.00% |
| IBSI HOLDINGS INC3 Filed as: IBSI HOLDING INC | 1381 OLD MILL CIRCLE #301 WINSTON-SALEM, NC 27103 | STANDARD INSURANCE COMPANY | $5K | $0 | $5K | 5.00% |
| BURCHFIELD INSURANCE GROUP INC3 Filed as: BURCHFIELD INSURANCE | P O BOX 3414 CONCORD, NC 28025 | AMERICAN GENERAL LIFE INSURANCE COMPANY | $2K | $0 | $2K | 9.98% |
| MOSAIC GROUP SERVICES3 Filed as: MOSAIC GROUP SVCS LLC | P O BOX 2291 DURHAM, NC 27702 | AMERICAN GENERAL LIFE INSURANCE COMPANY | $2K | $0 | $2K | 7.00% |
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 | 159 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 28 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 187 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | STANDARD INSURANCE COMPANY | 163 | $106K |
| Life insurance(2 contracts, 2 carriers) | MONY LIFE INSURANCE COMPANY OF AMERICA | 215 | $239K |
| Short-term disability(2 contracts, 2 carriers) | MONY LIFE INSURANCE COMPANY OF AMERICA | 215 | $239K |
| Long-term disability(2 contracts, 2 carriers) | MONY LIFE INSURANCE COMPANY OF AMERICA | 215 | $239K |
| Other | AMERICAN GENERAL LIFE INSURANCE COMPANY | 194 | $24K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 215 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.