| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 4819 EMPEROR BLVD STE 200 DURHAM, NC 27703 | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | $119K | — | $119K | 1.30% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 95287 CHICAGO, IL 60694 | HARTFORD LIFE AND ACCIDENT | $69K | — | $69K | 10.15% |
| MOSAIC GROUP SERVICES3 Filed as: MOSAIC GROUP SERVICES LLC | 4611 UNIVERSITY DR DURHAM, NC 27702 | HARTFORD LIFE AND ACCIDENT | — | $52K | $52K | 7.65% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD FLOOR 14 CHICAGO, IL 60604 | HARTFORD LIFE AND ACCIDENT | $6K | — | $6K | 0.95% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 4819 EMPEROR BLVD STE 200 DURHAM, NC 27703 | KAISER FOUNDATION HEALTH PLAN, INC. | $7K | — | $7K | 1.97% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD CHICAGO, IL 60604 | KAISER FOUNDATION HEALTH PLAN, INC. | $642 | — | $642 | 0.18% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 W GOLF RD 5TH FLOOR ROLLING MEADOWS, IL 60008 | SUN LIFE ASSURANCE COMPANY OF CANADA | $26K | $1K | $27K | 35.58% |
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 | 733 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 41 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 774 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 1,586 | $9.5M |
| Dental | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 1,586 | $9.2M |
| Vision | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 1,586 | $9.2M |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 758 | $676K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 758 | $676K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 758 | $676K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 1,586 | $9.2M |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 758 | $753K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,586 | — |
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.