| 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 | $23K | $1K | $24K | 2.82% |
| BANYAN CONSULTING GROUP INC3 | 333 N. GREENS ST STE 400 GREENSBORO, NC 27401 | USABLE LIFE | $4K | — | $4K | 11.25% |
| MOSAIC GROUP SERVICES3 Filed as: MOSAIC GROUP | PO BOX 2291 DURHAM, NC 27702 | USABLE LIFE | $2K | — | $2K | 6.47% |
| BANYAN CONSULTING GROUP INC3 | 333 N. GREENE ST STE 400 GREENSBORO, NC 27401 | USABLE LIFE | $3K | — | $3K | 11.21% |
| MOSAIC GROUP SERVICES3 Filed as: MOSAIC GROUP | PO BOX 2291 DURHAM, NC 27702 | USABLE LIFE | $1K | — | $1K | 6.44% |
| BANYAN CONSULTING GROUP INC3 | 333 N. GREENE ST STE 400 GREENSBORO, NC 27401 | USABLE | $2K | — | $2K | 11.26% |
| MOSAIC GROUP SERVICES3 Filed as: MOSAIC GROUP | PO BOX 2291 DURHAM, NC 27702 | USABLE | $1K | — | $1K | 6.47% |
| BANYAN CONSULTING GROUP INC3 | 333 N GREENE ST STE 301 GREENSBORO, NC 27401 | DEARBORN NATIONAL LIFE INSURANCE COMPANY | $286 | — | $286 | 15.00% |
| MOSAIC GROUP SERVICES3 Filed as: MOSAIC GROUP SERVICES LLC | PO BOX 2291 DURHAM, NC 27702 | DEARBORN NATIONAL LIFE INSURANCE COMPANY | — | $190 | $190 | 9.96% |
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 | 154 | 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) | 154 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 356 | $839K |
| Dental | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 356 | $839K |
| Life insurance | USABLE LIFE | 154 | $23K |
| Short-term disability | USABLE LIFE | 612 | $32K |
| Long-term disability | USABLE | 616 | $20K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 356 | $839K |
| Other(2 contracts, 2 carriers) | USABLE LIFE | 154 | $25K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 616 | — |
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.