| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | $35K | $2K | $38K | 2.80% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | MINNESOTA LIFE INSURANCE COMPANY | $56K | $18K | $74K | 9.04% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, FLOOR 4 ROLLING MEADOWS, IL 60008 | DELTA DENTAL OF NORTH CAROLINA | $14K | $0 | $14K | 9.22% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 21ST FLOOR ITASCA, IL 60143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $0 | $6K | 5.56% |
| BENEFITSTORE INC3 Filed as: BENEFITSTORE, INC. | LOCKBOX 893383 RICHARDSON, TX 75081 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $0 | $3K | 2.37% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $1 | $2K | 2.06% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $303 | $303 | 0.27% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 21ST FLOOR ITASCA, IL 60143 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $0 | $3K | 3.51% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $706 | $2K | 2.33% |
| BENEFITSTORE INC3 Filed as: BENEFITSTORE, INC. | LOCKBOX 893383 RICHARDSON, TX 75081 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $837 | $0 | $837 | 0.91% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $254 | $254 | 0.28% |
| BENEFIT COMMUNICATIONS INC3 Filed as: BENEFIT COMMUNICATIONS, INC. | 2977 SIDCO DRIVE NASHVILLE, TN 37204 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $232 | $0 | $232 | 0.25% |
| JOHNSON AND HIGGINS CAROLINAS, INC.3 | 1 FIRST UNION CENTER, SUITE 3900 CHARLOTTE, NC 28202 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $95 | $0 | $95 | 0.10% |
| MJ INSURANCE3 Filed as: LAWRENCE HOLDEN AND VARIOUS AGENTS | 100 NORTH CHERRY STREET, SUITE 500 WINSTON SALEM, NC 27101 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $51 | $0 | $51 | 0.06% |
| BENEFITSTORE INC3 Filed as: BENEFITSTORE, INC. | 100 BENEFITFOCUS WAY CHARLESTON, SC 29492 | ARAG INSURANCE COMPANY | $6K | $0 | $6K | 10.00% |
| BENEFITSTORE INC5 Filed as: BENEFITSTORE, INC. | 100 BENEFITFOCUS WAY CHARLESTON, SC 29492 | ARAG INSURANCE COMPANY | $0 | $3K | $3K | 5.00% |
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 | 2,330 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 15 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,345 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | 3,145 | $927K |
| Dental | DELTA DENTAL OF NORTH CAROLINA | 354 | $149K |
| Vision | VISION SERVICE PLAN | 1,618 | $367K |
| Life insurance(2 contracts, 2 carriers) | MINNESOTA LIFE INSURANCE COMPANY | 2,375 | $910K |
| Short-term disability | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | 3,459 | $1.4M |
| Long-term disability | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | 3,459 | $1.4M |
| Prescription drug | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | 3,145 | $927K |
| Other(6 contracts, 6 carriers) | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | 3,459 | $2.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,459 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.