| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CORESOURCE, INC.3 Filed as: CORESOURCE, INC | 2105 WATER RIDGE PARKWAY SUITE 600 CHARLOTTE, NC 28217 | HCC LIFE INSURANCE COMPANY | — | $3K | $3K | 1.54% |
| CORESOURCE, INC.3 Filed as: CORESOURCE, INC | 18401 MAPLE CREEK DRIVE SUITE 300 TINLEY PARK, IL 60477 | HCC LIFE INSURANCE COMPANY | — | $932 | $932 | 0.46% |
| CORESOURCE, INC.3 Filed as: CORESOURCE, INC | 400 FIELD DRIVE LAKE FOREST, IL 60045 | AMERICAN GENERAL LIFE INSURANCE COMPANY | $617 | — | $617 | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CORESOURCE, INC. EIN 35-1846036 NONE | Claims processing; Plan Administrator; Other services Service code 12 | — | $68K |
| CIGNA PPO EIN 59-1031071 NONE | Claims processing Service code 12 | — | $18K |
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 | 122 | 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) | 122 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | AMERICAN GENERAL LIFE INSURANCE COMPANY | 106 | $6K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 122 | $202K |
| Other(2 contracts, 2 carriers) | NATION UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA | 120 | $17K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 122 | — |
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.