| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CHARLES S JONES3 | PO BOX 29004 GREENSBORO, NC 27429 | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | $25K | — | $25K | 1.81% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 350 CONSHOHOCKEN, PA 19428 | PRINCIPAL LIFE INSURANCE COMPANY | $25K | — | $25K | 10.49% |
| MOSAIC GROUP SERVICES3 Filed as: MOSAIC GROUP SERVICES LLC | PO BOX 2291 DURHAM, NC 27702 | PRINCIPAL LIFE INSURANCE COMPANY | $10K | — | $10K | 4.17% |
| JOHN F ROSSER JR3 | 629 GREEN VALLEY ROAD SUITE 202 GREENSBORO, NC 27408 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $18K | — | $18K | 15.56% |
| MARSH & MCLENNAN AGENCY LLC3 | 1031 W 4TH AVENUE, STE 400 ANCHORAGE, AK 99501 | CONTINENTAL AMERICAN INSURANCE COMPANY | $4K | — | $4K | 23.63% |
| BRANDON HARVEY3 | 4529 TREEBARK LANE HIGH POINT, NC 27265 | CONTINENTAL AMERICAN INSURANCE COMPANY | $3K | — | $3K | 14.13% |
| SELECT BENEFIT SOLUTION LLC3 | 950 GRAVES STREET, STE D KERNERSVILLE, NC 27285 | CONTINENTAL AMERICAN INSURANCE COMPANY | $676 | — | $676 | 3.70% |
| JEREMY M HASKELL3 | 3265 SE 21ST AVE OCALA, FL 34471 | CONTINENTAL AMERICAN INSURANCE COMPANY | $140 | — | $140 | 0.77% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLELLAN AGENCY LLC | PO BOX 350 CONSHOHOCKEN, PA 19428 | VISION SERVICE PLAN | $929 | — | $929 | 6.62% |
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 | 141 | 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) | 141 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 175 | $1.4M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 229 | $239K |
| Vision | VISION SERVICE PLAN | 120 | $14K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 229 | $239K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 229 | $239K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 229 | $239K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 175 | $1.4M |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 150 | $137K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 229 | — |
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.