| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MOSAIC GROUP SERVICES3 | PO BOX 2291 DURHAM, NC 27702 | USABLE LIFE | $3K | $0 | $3K | 7.00% |
| THRIVE BENEFITS LLC3 | 211 EAST BLVD CHARLOTTE, NC 28203 | USABLE LIFE | $3K | $0 | $3K | 5.38% |
| BALDWIN KRYSTYN SHERMAN PARTNERS3 | 4211 W BOY SCOUT BLVD SUITE 900 TAMPA, FL 33607 | USABLE LIFE | $2K | $0 | $2K | 4.62% |
| THRIVE BENEFITS LLC3 | PO BOX 49352 CHARLOTTE, NC 28277 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 5.26% |
| BALDWIN KRYSTYN SHERMAN PARTNERS3 | 4211 WEST BOY SCOUT BLVD SUITE 900 TAMPA, FL 33607 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 4.74% |
| THRIVE BENEFITS LLC3 | 211 EAST BLVD CHARLOTTE, NC 28203 | USABLE LIFE | $4K | $0 | $4K | 8.10% |
| MOSAIC GROUP SERVICES3 | PO BOX 2291 DURHAM, NC 27702 | USABLE LIFE | $3K | $0 | $3K | 7.00% |
| BALDWIN KRYSTYN SHERMAN PARTNERS3 | 4211 W BOY SCOUT BLVD SUITE 900 TAMPA, FL 33607 | USABLE LIFE | $3K | $0 | $3K | 6.90% |
| MOSAIC GROUP SERVICES3 | PO BOX 2291 DURHAM, NC 27702 | USABLE LIFE | $2K | $0 | $2K | 7.00% |
| THRIVE BENEFITS LLC3 | 211 EAST BLVD CHARLOTTE, NC 28203 | USABLE LIFE | $2K | $0 | $2K | 5.39% |
| BALDWIN KRYSTYN SHERMAN PARTNERS3 | 4211 W BOY SCOUT BLVD SUITE 900 TAMPA, FL 33607 | USABLE LIFE | $1K | $0 | $1K | 4.61% |
| THRIVE BENEFITS LLC3 | 211 EAST BLVD CHARLOTTE, NC 28203 | AMERITAS LIFE INSURANCE CORP | $1K | $0 | $1K | 8.86% |
| BALDWIN KRYSTYN SHERMAN PARTNERS3 | 4211 W BOY SCOUT BLVD SUITE 800 TAMPA, FL 33607 | AMERITAS LIFE INSURANCE CORP | $791 | $0 | $791 | 6.15% |
| MOSAIC GROUP SERVICES3 | PO BOX 2291 DURHAM, NC 27702 | USABLE LIFE | $371 | $0 | $371 | 7.01% |
| THRIVE BENEFITS LLC3 | 211 EAST BLVD CHARLOTTE, NC 28203 | USABLE LIFE | $289 | $0 | $289 | 5.46% |
| BALDWIN KRYSTYN SHERMAN PARTNERS3 | 4211 W BOY SCOUT BLVD SUITE 900 TAMPA, FL 33607 | USABLE LIFE | $241 | $0 | $241 | 4.55% |
| THRIVE BENEFITS LLC3 | 211 EAST BLVD CHARLOTTE, NC 28203 | USABLE LIFE | $261 | $0 | $261 | 8.05% |
| MOSAIC GROUP SERVICES3 | PO BOX 2291 DURHAM, NC 27702 | USABLE LIFE | $227 | $0 | $227 | 7.00% |
| BALDWIN KRYSTYN SHERMAN PARTNERS3 | 4211 W BOY SCOUT BLVD SUITE 900 TAMPA, FL 33607 | USABLE LIFE | $225 | $0 | $225 | 6.94% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| TRUSTMARK HEALTH BENEFITS INC EIN 35-1846036 NONE | Plan Administrator; Claims processing; Other services Service code 12 | — | $203K |
| THRIVE BENEFITS LLC EIN 83-1381826 DENTALBROKER | Insurance agents and brokers; Consulting (general) Service code 16 | — | $70K |
| BALDWIN KRYSTYN SHERMAN PARTNERS EIN 20-4102683 BROKER/MEDICAL | Insurance agents and brokers Service code 22 | — | $65K |
| CIGNA PPO EIN 59-1031071 NONE | Claims processing; Other services Service code 12 | — | $48K |
| AMERITAS LIFE INSURANCE CORP EIN 47-0098400 DENTAL ADMIN | Claims processing Service code 12 | — | $16K |
| HEALTHCARE BLUEBOOK EIN 46-4399706 NONE | Other services; Plan Administrator; Claims processing Service code 12 | — | $8K |
| TELEDOC EIN 04-3705970 TELEDOC | Custodial (securities); Claims processing; Plan Administrator Service code 12 | — | $5K |
| BALDWIN KRYSTYN SHERMAN PARTNERS LL EIN 20-4102683 DENTAL BROKER | Insurance agents and brokers Service code 22 | — | $5K |
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 | 160 | 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) | 160 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | AMERITAS LIFE INSURANCE CORP | 99 | $13K |
| Life insurance | USABLE LIFE | 160 | $5K |
| Short-term disability | USABLE LIFE | 160 | $28K |
| Long-term disability | USABLE LIFE | 160 | $49K |
| Other(4 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 160 | $99K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 160 | — |
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.