| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST INC. | 29754 NETWORK PLACE CHICAGO, IL 60673 | HARTFORD LIFE AND ACCIDENT | $15K | — | $15K | 8.61% |
| MOSAIC GROUP SERVICES3 Filed as: MOSAIC GROUP SERVICES, LLC | 4611 UNIVERSITY DR. DURHAM, NC 27702 | HARTFORD LIFE AND ACCIDENT | — | $12K | $12K | 7.00% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC. | 1125 SANCTUARY PARKWAY ALPHARETTA, GA 30009 | HARTFORD LIFE AND ACCIDENT | $11K | $892 | $12K | 6.90% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE SERV | 801 S FIGUEROA STREET LOS ANGELES, CA 90017 | HARTFORD LIFE AND ACCIDENT | — | $2K | $2K | 1.09% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST, INC | ASHLEY BAILEYREG.ACCTOORD. PO BOX 905643 CHARLOTTE, NC 28290 | DELTA DENTAL OF NORTH CAROLINA | $960 | — | $960 | 0.98% |
| ALLIANT INSURANCE SERVICES, INC.3 | 353 N. CLARK ST. FL 10 CHICAGO, IL 60654 | DELTA DENTAL OF NORTH CAROLINA | $647 | — | $647 | 0.66% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST INC. | 214 N. TRYON ST. STE 2500 CHARLOTTE, NC 28202 | UNITEDHEALTHCARE INSURANCE COMPANY | $5K | — | $5K | 22.73% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES | PO BOX 8299 PASADENA, CA 91109 | VISION SERVICE PLAN | $674 | — | $674 | 5.87% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST | 29754 NETWORK PLACE CHICAGO, IL 60673 | VISION SERVICE PLAN | $473 | — | $473 | 4.12% |
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 | 150 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 150 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 193 | $1.6M |
| Dental | DELTA DENTAL OF NORTH CAROLINA | 217 | $98K |
| Vision | VISION SERVICE PLAN | 92 | $11K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 150 | $176K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 150 | $176K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 150 | $176K |
| Prescription drug | UNITEDHEALTHCARE INSURANCE COMPANY | 193 | $1.6M |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 150 | $198K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 217 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.