| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KURT DEGROSZ3 | 777 MARINERS ISLAND BOULEVARD SUITE 250 SAN MATEO, CA 94404 | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | $28K | $0 | $28K | 0.97% |
| CHAD HUFF3 | 7470 CRAIG BERRY COURT RURAL HALL, NC 27045 | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | $25K | $0 | $25K | 0.89% |
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF NORTH CAROLINA LLC | 530 NORTH TRADE STREET, SUITE 302 WINSTON SALEM, NC 27101 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $24K | $0 | $24K | 10.82% |
| ABD INS. AND FINANCIAL SVCS., INC.3 | 777 MARINERS ISLAND BOULEVARD SUITE 250 SAN MATEO, CA 94404 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $21K | $0 | $21K | 9.18% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $36 | $36 | 0.02% |
| HILB GROUP OF NEW ENGLAND3 Filed as: HILB GROUP OF NORTH CAROLINA LLC | 119 BROOKSTOWN AVENUE, SUITE 203 WINSTON SALEM, NC 27101 | COMPANION LIFE INSURANCE COMPANY | $12K | $0 | $12K | 6.31% |
| ABD INS. AND FINANCIAL SVCS., INC.3 | 777 MARINERS ISLAND BOULEVARD SUITE 250 SAN MATEO, CA 94404 | COMPANION LIFE INSURANCE COMPANY | $7K | $0 | $7K | 3.69% |
| THE CASON GROUP INC3 Filed as: THE CASON GROUP | 1612 MARION STREET COLUMBIA, SC 29201 | COMPANION LIFE INSURANCE COMPANY | $7K | $0 | $7K | 3.61% |
| NATIONAL ENROLLMENT PARTNERS LLC3 Filed as: NATIONAL ENROLLMENT PARTNERS | 8575 WEST 110TH STREET, SUITE 210 OVERLAND PARK, KS 66210 | COMPANION LIFE INSURANCE COMPANY | $3K | $0 | $3K | 1.39% |
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 | 207 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 216 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 474 | $2.9M |
| Dental | COMPANION LIFE INSURANCE COMPANY | 76 | $184K |
| Vision | COMPANION LIFE INSURANCE COMPANY | 76 | $184K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 207 | $223K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 207 | $223K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 207 | $223K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 474 | $2.9M |
| Other(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 207 | $223K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 474 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.