| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NORTH CAROLINA, INC. | 214 NORTH TRYON STREET, SUITE 2500 CHARLOTTE, NC 28202 | METROPOLITAN LIFE INSURANCE COMPANY | $26K | $31 | $26K | 2.25% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NORTH CAROLINA, INC. | PO BOX 31817 CHARLOTTE, NC 28231 | METROPOLITAN LIFE INSURANCE COMPANY | — | $21K | $21K | 1.80% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NORTH CAROLINA, INC. | 214 NORTH TRYON STREET, SUITE 2500 CHARLOTTE, NC 28202 | KAISER FOUNDATION HEALTH PLAN INC | $25K | — | $25K | 2.96% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NORTH CAROLINA, INC. | 301 SOUTH TRYON STREET, SUITE 2600 CHARLOTTE, NC 28282 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $35K | $10K | $45K | 6.94% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NORTH CAROLINA, INC. | 214 NORTH TRYON STREET, SUITE 2500 CHARLOTTE, NC 28202 | VISION SERVICE PLAN | $13K | — | $13K | 10.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NORTH CAROLINA, INC. | 301 SOUTH TRYON STREET, SUITE 2600 CHAROLOTTE, NC 28282 | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | $852 | $32 | $884 | 20.76% |
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 | 1,610 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 23 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,633 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 162 | $842K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 2,523 | $1.1M |
| Vision | VISION SERVICE PLAN | 1,199 | $126K |
| Life insurance | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 1,610 | $651K |
| Long-term disability | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 1,610 | $651K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 162 | $842K |
| Other(2 contracts, 2 carriers) | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 1,610 | $655K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,523 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.