| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST | PO BOX 13784 NEWARK, NJ 07188 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $58K | — | $58K | 3.96% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST | PO BOX 31817 CHARLOTTE, NC 28231 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $54K | — | $54K | 7.65% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST, INC | 12505 PARK POTOMAC AVE STE 300 POTOMAC, MD 20854 | KAISER FOUNDATION HEALTH PLAN, INC. | $21K | — | $21K | 3.20% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NORTH CAROLINA, INC. | 29754 NETWORK PL CHICAGO, IL 60673 | VISION SERVICE PLAN | $23K | — | $23K | 9.18% |
| WILLIS TOWERS WATSON US LLC Filed as: WILLIS TOWERS WATSON SOUTH | 29754 NETWORK PLACE CHICAGO, IL 60673 | NEW YORK GROUP INSURANCE COMPANY OF NY | $16K | — | $16K | 10.00% |
| WILLIS TOWERS WATSON US LLC Filed as: WILLIS TOWERS WATSON SOUTH | 29754 NETWORK PLACE CHICAGO, IL 60673 | NEW YORK GROUP INSURANCE COMPANY OF NY | $15K | — | $15K | 10.00% |
| GREG I HINRICHS3 | 11111 CARMEL COMMONS BLVD SUITE 125 CHARLOTTE, NC 28226 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $4K | $7K | $12K | 9.18% |
| DANIEL WARD RICHARDSON3 | 11111 CARMEL COMMONS BLVD SUITE 125 CHARLOTTE, NC 28226 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $5K | — | $5K | 3.63% |
| JAMES WILLIAM DEUINK3 | 11111 CARMEL COMMONS BLVD SUITE 125 CHARLOTTE, NC 28226 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $4K | — | $4K | 3.47% |
| AFFINITY LTC, LLC3 | 6201 PRESIDENTIAL COURT FORT MYERS, FL 33919 | GENWORTH LIFE INSURANCE COMPANY | $4K | — | $4K | 9.14% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST | 29754 NETWORK PL SUITE 2500 CHICAGO, IL 606731297 | GENWORTH LIFE INSURANCE COMPANY | $965 | — | $965 | 2.03% |
| GREG I HINRICHS3 | 11111 CARMEL COMMONS BLVD SUITE 125 CHARLOTTE, NC 28226 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $3K | $5K | 10.51% |
| DANIEL WARD RICHARDSON3 | 11111 CARMEL COMMONS BLVD SUITE 125 CHARLOTTE, NC 28226 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 3.80% |
| JAMES WILLIAM DEUINK3 | 11111 CARMEL COMMONS BLVD SUITE 125 CHARLOTTE, NC 28226 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 3.65% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON, INC | 214 N TRYON STREET SUITE 2500 CHARLOTTE, NC 28202 | METLIFE LEGAL PLANS | $3K | — | $3K | 10.89% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF TENNESSEE | 29982 NETWORK PLACE CHICAGO, IL 60673 | METLIFE LEGAL PLANS | — | $500 | $500 | 1.80% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF TENNESSEE, INC. | 265 BROOKVIEW CENTRE WAY SUITE 505 KNOXVILLE, TN 37919 | METLIFE LEGAL PLANS | — | $28 | $28 | 0.10% |
| MICHAEL S VANGAVREE3 | C/O LTC GLOBAL 6201 PRESIDENTIAL COURT FORT MYERS, FL 33919 | GENWORTH LIFE INSURANCE COMPANY | $2K | — | $2K | 8.39% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST INC. | 29754 NETWORK PLACE CHICAGO, IL 606731297 | GENWORTH LIFE INSURANCE COMPANY | $339 | — | $339 | 1.87% |
| AFFINITY LTC, LLC3 | C/O LTC GLOBAL 6201 PRESIDENTIAL COURT FORT MYERS, FL 33919 | GENWORTH LIFE INSURANCE COMPANY | $917 | — | $917 | 9.40% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST INC | 29754 NETWORK PLACE CHICAGO, IL 606731297 | GENWORTH LIFE INSURANCE COMPANY | $204 | — | $204 | 2.09% |
| MICHAEL S VANGAVREE3 | C/O LTC GLOBAL 6201 PRESIDENTIAL COURT FORT MYERS, FL 33919 | GENWORTH LIFE INSURANCE COMPANY | $290 | — | $290 | 8.84% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST INC. | 29754 NETWORK PLACE CHICAGO, IL 606731297 | GENWORTH LIFE INSURANCE COMPANY | $65 | — | $65 | 1.98% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTH | 29754 NETWORK PLACE CHICAGO, IL 60673 | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | — | $46 | $46 | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ANTHEM BLUE CROSS LIFE AND HEALTH I EIN 95-4331852 TPA | Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Contract Administrator; Claims processing Service code 12 | — | $1.3M |
| WILLIS OF NORTH CAROLINA, INC. BROKER | Insurance brokerage commissions and fees; Other commissions; Insurance agents and brokers Service code 22 | 301 S TRYON ST SUITE 2600 CHARLOTTE, NC 28282 | $0 |
| INGENIORX, INC. EIN 82-3062245 RX REBATES AND ADMIN FEE | Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Other services; Float revenue Service code 12 | — | -$129K |
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 | 2,045 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 103 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 40 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,188 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN, INC. | 133 | $658K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,814 | $1.5M |
| Vision | VISION SERVICE PLAN | 1,495 | $249K |
| Life insurance | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 2,113 | $708K |
| Long-term disability(3 contracts, 3 carriers) | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 2,011 | $502K |
| Other(10 contracts, 6 carriers) | NEW YORK GROUP INSURANCE COMPANY OF NY | 2,034 | $584K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,113 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.