| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| J. ARTHUR DAIL, INC.3 | 6000 FAIRVIEW RD STE 1180 CHARLOTTE, NC 28210 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $47K | — | $47K | 23.00% |
| J. ARTHUR DAIL, INC.3 | 6000 FAIRVIEW DR, SUITE 1180 CHARLOTTE, NC 28210 | COMMUNITY EYE CARE | $5K | — | $5K | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PLANNED ADMINISTRATORS, INC. EIN 57-0718839 CONTRACT ADMINISTRATOR | Contract Administrator; Claims processing Service code 12 | — | $102K |
| BLUE CROSS BLUE SHIELD OF SC EIN 57-0287419 UR/CM/DENTAL/PPO NETWORK | Contract Administrator; Insurance services; Other services; Claims processing Service code 12 | — | $0 |
| FIRSTHEALTH EIN 20-1736437 PPO NETWORK ACCESS FEES | Other services Service code 49 | — | $0 |
| J. ARTHUR DAIL, INC. EIN 58-1902702 BROKER AND CONSULTANT | Insurance agents and brokers Service code 22 | — | $0 |
| SOUTHERN SCRIPTS EIN 47-4999303 PBM | Claims processing; Contract Administrator Service code 12 | — | $0 |
| WAGE WORKS, INC. EIN 94-3351864 COBRA ADMINISTRATION | Contract Administrator Service code 13 | — | $0 |
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 | 426 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 122 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 548 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | COMMUNITY EYE CARE | 674 | $55K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 504 | $206K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 504 | $206K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 504 | $206K |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 504 | $206K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 674 | — |
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.