| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLEN TATE INSURANCE SERVICES, LLC3 Filed as: ALLEN TATE INSURANCE SERVICES LLC | 6207 PARK SOUTH DRIVE, SUITE 201 CHARLOTTE, NC 28210 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $1K | $104K | $105K | 5.06% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS ADMIN LLC | PO BOX 310502 DES MOINES, IA 50331 | HARTFORD LIFE AND ACCIDENT | $31K | — | $31K | 17.22% |
| MOSAIC GROUP SERVICES3 Filed as: MOSAIC GROUP SERVICES LLC | 4611 UNIVERSITY DR DURHAM, NC 27702 | HARTFORD LIFE AND ACCIDENT | — | $17K | $17K | 9.32% |
| ALLEN TATE INSURANCE SERVICES, LLC3 | 6207 PARK SOUTH, SUITE 201 CHARLOTTE, NC 28210 | HARTFORD LIFE AND ACCIDENT | $10K | — | $10K | 5.54% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HUMAN RESOURCE CONSULTING | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | HARTFORD LIFE AND ACCIDENT | — | $280 | $280 | 0.16% |
| ALLEN TATE INSURANCE SERVICES, LLC3 | 6207 PARK SOUTH DRIVE, SUITE 201 CHARLOTTE, NC 28210 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $13K | $1K | $14K | 10.78% |
| ALLEN TATE INSURANCE SERVICES, LLC3 | 6207 PARK SOUTH CHARLOTTE, NC 28210 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $2K | — | $2K | 10.17% |
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 | 258 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 266 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 283 | $2.3M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 176 | $133K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 262 | $19K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 283 | $178K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 283 | $178K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 283 | $178K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 271 | $2.1M |
| Other | HARTFORD LIFE AND ACCIDENT | 283 | $178K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 283 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
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.