| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BRANDON MOOREFIELD3 | 2301 SUGAR BUSH ROAD SUITE 600 RALEIGH, NC 27612 | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | $53K | — | $53K | 1.05% |
| CHAD HUFF3 | P O BOX 25172 WINSTON SALEM, NC 27114 | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | $34K | — | $34K | 0.68% |
| GREG GIBSON3 | PO BOX 2320 WILMINGTON, NC 28401 | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | $25K | — | $25K | 0.50% |
| WENDY PACE3 | POST OFFICE BOX 33789 CHARLOTTE, NC 28233 | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | $17K | — | $17K | 0.34% |
| WILLIAM A PORTER JR3 Filed as: WILLIAM JENKINS III | 105 EAST ARLINGTON BLVD. GREENVILLE, NC 27858 | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | $1K | — | $1K | 0.02% |
| HAROLD W WELLS & SONS INC3 Filed as: HAROLD W WELLS & SON INC | 1 N 3RD ST WILMINGTON, NC 28401 | USABLE LIFE | $2K | $145 | $2K | 6.97% |
| MOSAIC GROUP SERVICES3 | PO BOX 2291 DURHAM, NC 27702 | USABLE LIFE | $2K | — | $2K | 5.99% |
| MARSH & MCLENNAN AGENCY LLC3 | 161 WASHINGTON ST STE 1200 CONSHOHOCKEN, PA 19428 | USABLE LIFE | $775 | $287 | $1K | 3.72% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BUSINESSOLVER EIN 42-1503807 NONE | Contract Administrator Service code 13 | — | $87K |
| NCHBA PLAN ADMINISTRATOR | Plan Administrator Service code 14 | 5580 CENTERVIEW DR STE 415 RALEIGH, NC 27206 | $45K |
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 | 706 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 712 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 1,134 | $5.0M |
| Dental | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 1,134 | $5.0M |
| Vision | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 1,134 | $5.0M |
| Life insurance | USABLE LIFE | 249 | $29K |
| Long-term disability | USABLE LIFE | 249 | $29K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 1,134 | $5.0M |
| Other(2 contracts, 2 carriers) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 1,134 | $5.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,134 | — |
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.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.