| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASCENSION INSURANCE AGENCY3 Filed as: ASCENSION INSURANCE AGENCY, INC. | 5821 FAIRVIEW ROAD, SUITE 500 CHARLOTTE, NC 28209 | AETNA LIFE INSURANCE COMPANY | $20K | $0 | $20K | 11.45% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 600 HIGHWAY 169 SOUTH, SUITE 1200 SAINT LOUIS PARK, MN 55426 | AETNA LIFE INSURANCE COMPANY | -$2K | $4K | $2K | 1.29% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 300 NORTH GREENE STREET, 6TH FLOOR GREENBORO, NC 27401 | AETNA LIFE INSURANCE COMPANY | $0 | $67 | $67 | 0.04% |
| RELATION INSURANCE INC3 Filed as: RELATION INSURANCE | 2290 HUNTINGTON DRIVE, SUITE 200 SAN MARINO, CA 91108 | USABLE LIFE | $3K | $0 | $3K | 15.00% |
| MOSAIC GROUP SERVICES3 | PO BOX 2291 DURHAM, NC 27702 | USABLE LIFE | $2K | $200 | $2K | 11.09% |
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 | 155 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 155 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | AETNA LIFE INSURANCE COMPANY | 458 | $173K |
| Life insurance | USABLE LIFE | 161 | $18K |
| Short-term disability | AETNA LIFE INSURANCE COMPANY | 458 | $173K |
| Long-term disability | AETNA LIFE INSURANCE COMPANY | 458 | $173K |
| Other | USABLE LIFE | 161 | $18K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 458 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.