| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GROUP BENEFIT SOLUTIONS3 | 588 DAVIDSON GATEWAY DRIVE DAVIDSON, NC 28036 | CIGNA | $43K | $0 | $43K | 13.20% |
| GROUP BENEFIT SOLUTIONS3 | 580 DAVIDSON GATEWAY DRIVE DAVIDSON, NC 28036 | THE STANDARD | $8K | $0 | $8K | 7.60% |
| IBSI HOLDINGS INC3 Filed as: IBSI HOLDING INC | 1381 OLD MILL CIRCLE #301 WINSTON SALEM, NC 27103 | THE STANDARD | $6K | $0 | $6K | 5.60% |
| GROUP BENEFIT SOLUTIONS3 | 580 DAVIDSON GATEWAY DRIVE DAVIDSON, NC 28036 | THE STANDARD | $8K | $0 | $8K | 14.16% |
| IBSI HOLDINGS INC3 Filed as: IBSI HOLDINGS | 1381 OLD MILL CIRCLE #301 WINSTON SALEM, NC 27103 | THE STANDARD | $6K | $0 | $6K | 10.44% |
| GROUP BENEFIT SOLUTIONS3 | 580 DAVIDSON GATEWAY DRIVE DAVIDSON, NC 28036 | RELIANCE STANDARD | $4K | $0 | $4K | 14.99% |
| IBSI HOLDINGS INC3 | 1381 OLD MILL CIRCLE #301 WINSTON SALEM, NC 27103 | RELIANCE STANDARD | $729 | $0 | $729 | 3.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA EIN 59-1031071 CLAIMS ADMINISTRATOR | Claims processing; Non-monetary compensation; Direct payment from the plan; Float revenue; Other services; Contract Administrator; Named fiduciary; Participant communication Service code 12 | EASTWAY DRIVE CHARLOTTE, NC 28205 | $89K |
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. |
| Total participants (= "Plan participants" tile) | 122 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA | 123 | $328K |
| Dental | THE STANDARD | 122 | $103K |
| Life insurance | THE STANDARD | 122 | $55K |
| Long-term disability | RELIANCE STANDARD | 116 | $24K |
| Prescription drug | CIGNA | 123 | $328K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 123 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.