| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TERRY G ATHIAS3 Filed as: TERRY G ATHAS | 353 NORTH CLARK STREET CHICAGO, IL 60654 | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | $18K | — | $18K | 2.19% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INS SVCS HOUSTON LLC | 200 S WACKER DR STE 3030 CHICAGO, IL 60606 | HARTFORD LIFE AND ACCIDENT | $7K | — | $7K | 16.04% |
| MOSAIC GROUP SERVICES3 Filed as: MOSAIC GROUP SERVICES, LLC | 4611 UNIVERSITY DR DURHAM, NC 27702 | HARTFORD LIFE AND ACCIDENT | $3K | — | $3K | 7.00% |
| WEBTPA EMPLOYER SERVICES LLC3 | 8500 FREEPORT PKWY SOUTH IRVING, TX 75063 | HARTFORD LIFE AND ACCIDENT | — | $1K | $1K | 2.25% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SVCS INC | 701 B STREET 6TH FLR SAN DIEGO, CA 92101 | HARTFORD LIFE AND ACCIDENT | — | $124 | $124 | 0.27% |
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 | 169 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 172 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | 235 | $856K |
| Dental | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | 235 | $811K |
| Vision | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | 235 | $811K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 57 | $45K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 57 | $45K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 57 | $45K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | 235 | $811K |
| Other(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | 235 | $856K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 235 | — |
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.