| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EBENCONCEPTS COMPANY3 | 3150 NORTH ELM STE 201 GREENSBORO, NC 27408 | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | $37K | — | $37K | 0.78% |
| EBENCONCEPTS COMPANY3 | 3150 NORTH ELM STREET STE 201 GREENSBORO, NC 27408 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $26K | $9K | $35K | 20.00% |
| MOSAIC GROUP SERVICES3 Filed as: MOSAIC GROUP SERVICES LLC | 4613 UNIVERSITY DRIVE DURHAM, NC 27707 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $16K | $16K | 9.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EBENCONCEPTS COMPANY EIN 75-2966596 CONSULTANT | Consulting fees Service code 70 | — | $42K |
| SUN LIFE ASSURANCE COMPANY OF CANAD EIN 38-1082080 CLAIMS/FMLA ADMIN | Claims processing; Other fees Service code 12 | — | $19K |
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 | 562 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 562 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 817 | $4.8M |
| Dental | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 817 | $4.8M |
| Vision | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 817 | $4.8M |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 562 | $176K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 562 | $176K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 817 | $4.8M |
| Other(2 contracts, 2 carriers) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 817 | $5.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 817 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.