| 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 | $3K | — | $3K | 0.11% |
| RSC INSURANCE BROKERAGE INC3 | 4TH FLOOR 160 FEDERAL STREET BOSTON, MA 02110 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $23K | -$8K | $15K | 9.75% |
| MOSAIC GROUP SERVICES3 Filed as: MOSAIC GROUP SERVICES LLC | 4613 UNIVERSITY DRIVE DURHAM, NC 27707 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $8K | $9K | 5.91% |
| RSC INSURANCE BROKERAGE INC3 | 4TH FLOOR 160 FEDERAL DRIVE BOSTON, MA 02110 | UNUM INSURANCE COMPANY | $5K | $1K | $6K | 19.81% |
| MOSAIC GROUP SERVICES3 Filed as: MOSAIC GROUP SERVICES LLC | 4613 UNIVERSITY DRIVE DURHAM, NC 27707 | UNUM INSURANCE COMPANY | — | $3K | $3K | 9.57% |
| RSC INSURANCE BROKERAGE INC3 | 4TH FLOOR 160 FEDERAL STREET BOSTON, MA 02110 | FIRST UNUM LIFE INSURANCE COMPANY | $736 | $200 | $936 | 53.61% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EBENCONCEPTS COMPANY EIN 75-2966596 CONSULTANT | Consulting fees Service code 70 | — | $21K |
| UNUM LIFE INSURANCE COMPANY OF AMER EIN 01-0278678 ADMINISTRATOR | Claims processing; Contract Administrator Service code 12 | — | $14K |
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 | 596 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 596 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 529 | $3.1M |
| Dental | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 529 | $3.1M |
| Vision | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 529 | $3.1M |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 596 | $154K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 596 | $154K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 529 | $3.1M |
| Other(4 contracts, 4 carriers) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 596 | $3.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 596 | — |
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.