| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLEGACY BENEFIT SOLUTIONS LLC3 Filed as: ALLEGACY BENEFIT SOLUTIONS, LLC | POST OFFICE BOX 25172 WINSTON-SALEM, NC 27114 | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | $46K | — | $46K | 2.30% |
| ALLEGACY BENEFIT SOLUTIONS LLC3 Filed as: ALLEGACY BENEFIT SOLUTIONS, LLC | P O BOX 25172 1691 WESTBROOK PLAZA DR WINSTON-SALEM, NC 27114 | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | $9K | — | $9K | 3.00% |
| ALLEGACY BENEFIT SOLUTIONS LLC3 Filed as: ALLEGACY BENEFIT SOLUTIONS, LLC | P.O. BOX 25172 WINSTON SALEM, NC 27114 | UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY | $19K | $4K | $23K | 11.85% |
| ALLEGACY BENEFIT SOLUTIONS LLC3 Filed as: ALLEGACY BENEFIT SOLUTIONS, LLC | P.O. BOX 215712 WINSTON-SALEM, NC 27114 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $21K | $1K | $23K | 13.62% |
| ALLEGACY BENEFIT SOLUTIONS LLC3 Filed as: ALLEGACY BENEFIT SOLUTIONS, LLC | POST OFFICE BOX 25172 WINSTON-SALEM, NC 27114 | UNUM LIFE INSURANCE OF AMERICA | $5K | $378 | $5K | 10.75% |
| ALLEGACY BENEFIT SOLUTIONS LLC3 Filed as: ALLEGACY BENEFIT SOLUTIONS, LLC | 1691 WESTBROOK PLAZA DRIVE WINSTON-SALEM, NC 27103 | COMMUNITY EYE CARE | $3K | — | $3K | 10.00% |
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 | 253 | 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) | 253 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | 376 | $2.3M |
| Dental | UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY | 139 | $197K |
| Vision | COMMUNITY EYE CARE | 401 | $30K |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 277 | $216K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 277 | $166K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 277 | $166K |
| Prescription drug(2 contracts) | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | 376 | $2.3M |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 277 | $166K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 401 | — |
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."
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.