| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DAVID TATE3 Filed as: DAVID D DOW JR. | 333 N GREENE ST STE 400 GREENBORO, NC 27401 | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | $26K | — | $26K | 3.28% |
| MOSAIC GROUP SERVICES3 Filed as: MOSAIC GROUP | PO BOX 2291 DURHAM, NC 27702 | USABLE LIFE | $3K | — | $3K | 10.17% |
| BANYAN CONSULTING GROUP INC3 | 333 N. GREENS ST STE 400 GREENSBORO, NC 27401 | USABLE LIFE | $3K | — | $3K | 9.85% |
| MOSAIC GROUP SERVICES3 Filed as: MOSAIC GROUP | PO BOX 2291 DURHAM, NC 27702 | USABLE LIFE | $2K | — | $2K | 10.16% |
| BANYAN CONSULTING GROUP INC3 | 333 N. GREENE ST STE 400 GREENSBORO, NC 27401 | USABLE LIFE | $2K | — | $2K | 9.84% |
| MOSAIC GROUP SERVICES3 Filed as: MOSAIC GROUP | PO BOX 2291 DURHAM, NC 27702 | USABLE | $979 | — | $979 | 10.14% |
| BANYAN CONSULTING GROUP INC3 | 333 N. GREENE ST STE 400 GREENSBORO, NC 27401 | USABLE | $948 | — | $948 | 9.82% |
| MOSAIC GROUP SERVICES3 Filed as: MOSAIC GROUP SERVICES LLC | PO BOX 2291 DURHAM, NC 27702 | DEARBORN NATIONAL LIFE INSURANCE COMPANY | — | $309 | $309 | 14.68% |
| DWAYNE WILSON INSURANCE AND FINANCI3 Filed as: DWAYNE WILSON INS & FIN SRVCS INC. | PO BOX 336 MAIDEN, NC 286500336 | DEARBORN NATIONAL LIFE INSURANCE COMPANY | $290 | — | $290 | 13.78% |
| BANYAN CONSULTING GROUP INC3 | 333 N GREENE ST. STE 301 GREENSBORO, NC 27401 | DEARBORN NATIONAL LIFE INSURANCE COMPANY | $27 | — | $27 | 1.28% |
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 | 130 | 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) | 130 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 313 | $788K |
| Dental | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 313 | $788K |
| Vision | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 313 | $788K |
| Life insurance | USABLE LIFE | 130 | $20K |
| Short-term disability | USABLE LIFE | 68 | $30K |
| Long-term disability | USABLE | 66 | $10K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 313 | $788K |
| Other(2 contracts, 2 carriers) | USABLE LIFE | 130 | $22K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 313 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.