| 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 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $50K | — | $50K | 4.01% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NORTH CAROLINA, INC. | 214 NORTH TRYON STREET SUITE 2500 CHARLOTTE, NC 28202 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY* | $25K | — | $25K | 2.83% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NORTH CAROLINA, INC. | 214 NORTH TRYON STREET, SUITE 2500 CHARLOTTE, NC 282022381 | KAISER FOUNDATION HEALTH PLAN INC | $20K | — | $20K | 2.96% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF N CAROLINA | 214 NORTH TRYON ST SUITE 2500 CHARLOTTE, NC 28202 | LIBERTY LIFE ASSURANCE OF COMPANY OF BOSTON | $40K | $8K | $48K | 10.31% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NORTH CAROLINA, INC. | 214 NORTH TRYON STREET SUITE 2500 CHARLOTTE, NC 28202 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | — | $4K | $4K | 1.72% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NORTH CAROLINA, INC. | 214 NORTH TRYON STREET SUITE 2500 CHARLOTTE, NC 28202 | VISION SERVICE PLAN | $19K | — | $19K | 9.16% |
| GREG I HINRICHS3 | 11111 CARMEL COMMONS BLVD SUITE 125 CHARLOTTE, NC 28226 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $4K | $5K | $9K | 9.22% |
| DANIEL WARD RICHARDSON3 | 11111 CARMEL COMMONS BLVD SUITE 125 CHARLOTTE, NC 28226 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $4K | — | $4K | 4.19% |
| JAMES WILLIAM DEUINK3 | 11111 CARMEL COMMONS BLVD SUITE 125 CHARLOTTE, NC 28226 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $4K | — | $4K | 4.02% |
| GREG I HINRICHS3 | 11111 CARMEL COMMONS BLVD SUITE 125 CHARLOTTE, NC 28226 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $2K | $4K | 9.84% |
| DANIEL WARD RICHARDSON3 | 11111 CARMEL COMMONS BLVD SUITE 125 CHARLOTTE, NC 28226 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 4.29% |
| JAMES WILLIAM DEUINK3 | 11111 CARMEL COMMONS BLVD SUITE 125 CHARLOTTE, NC 28226 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 4.11% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NORTH CAROLINA | 214 NORTH TRYON STREET SUITE 2500 CHARLOTTE, NC 28202 | HYATT LEGAL PLANS | $2K | $304 | $2K | 13.80% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NORTH CAROLINA, INC. | 214 NORTH TRYON STREET, SUITE 2500 CHARLOTTE, NC 28282 | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | $852 | $68 | $920 | 21.61% |
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 | 1,713 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 55 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,768 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 129 | $686K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,583 | $1.2M |
| Vision | VISION SERVICE PLAN | 1,333 | $210K |
| Life insurance | LIBERTY LIFE ASSURANCE OF COMPANY OF BOSTON | 1,784 | $468K |
| Long-term disability(3 contracts, 3 carriers) | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 1,663 | $393K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 129 | $686K |
| Stop-loss / reinsurancereinsurance | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY* | 2,741 | $872K |
| Other(4 contracts, 4 carriers) | LIBERTY LIFE ASSURANCE OF COMPANY OF BOSTON | 1,784 | $512K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,741 | — |
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."
No prospect flags tripped on this filing.