| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DUANE KING3 | 1420 5TH AVENUE, 15TH FLOOR SEATTLE, WA 98101 | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | $43K | — | $43K | 1.62% |
| ALLIANT INSURANCE SERVICES, INC.3 | 1420 5TH AVENUE, SUITE 1500 SEATTLE, WA 98101 | HARTFORD LIFE AND ACCIDENT | $12K | $7K | $19K | 10.40% |
| MOSAIC GROUP SERVICES3 Filed as: MOSAIC GROUP SERVICES, LLC | PO BOX 2291 DURHAM, NC 27702 | HARTFORD LIFE AND ACCIDENT | $0 | $12K | $12K | 6.46% |
| INDIGO INSURANCE SERVICES3 Filed as: INDIGO INSURANCE SERVICES, LLC | 100 FRONT STREET, 20TH FLOOR WORCESTER, MA 01608 | HARTFORD LIFE AND ACCIDENT | $0 | $978 | $978 | 0.54% |
| HILB GROUP OF NEW ENGLAND3 Filed as: THE HILB GROUP OF NEW ENGLAND | 2000 CHAPEL VIEW BOULEVARD SUITE 240 CRANSTON, RI 02920 | HARTFORD LIFE AND ACCIDENT | $0 | $10 | $10 | 0.01% |
| HILB GROUP OF NEW ENGLAND3 Filed as: THE HILB GROUP OF NEW ENGLAND | 2 TRAP FALLS ROAD, SUITE 350 SHELTON, CT 06484 | HARTFORD LIFE AND ACCIDENT | -$15 | $0 | -$15 | -0.01% |
| ALLIANT INSURANCE SERVICES, INC.3 | 353 NORTH CLARK STREET, 10TH FLOOR CHICAGO, IL 60654 | DELTA DENTAL OF NORTH CAROLINA | $17K | $0 | $17K | 10.13% |
| ALLIANT INSURANCE SERVICES, INC.3 | PO BOX 8299 PASADENA, CA 91109 | TRUSTMARK INSURANCE COMPANY | $2K | — | $2K | 11.01% |
| BRANDON PENKO3 | 4927 MAGNOLIA BEND DRIVE ROSHARON, TX 77583 | TRUSTMARK INSURANCE COMPANY | $2K | — | $2K | 10.92% |
| BRENDAN P. QUINLAN3 | 575 MARKET STREET, SUITE 3600 SAN FRANCISCO, CA 94105 | ARAG INSURANCE COMPANY | $644 | $0 | $644 | 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 | 182 | 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) | 182 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | 491 | $2.7M |
| Dental | DELTA DENTAL OF NORTH CAROLINA | 354 | $168K |
| Vision | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | 491 | $2.7M |
| Life insurance(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 141 | $199K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 141 | $180K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 141 | $180K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | 491 | $2.7M |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 141 | $187K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 491 | — |
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.