| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 | 2301 SUGAR BUSH RD RALEIGH, NC 27612 | SUN LIFE ASSURANCE COMPANY OF CANADA | $63K | — | $63K | 10.87% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NORTH CAROLINA INC. | 301 S TRYON STREET CHARLOTTE, NC 28282 | DELTA DENTAL OF NORTH CAROLINA | $11K | — | $11K | 4.89% |
| MARSH & MCLENNAN AGENCY LLC3 | 2300 RENAISSANCE BLVD KING OF PRUSSIA, PA 19406 | DELTA DENTAL OF NORTH CAROLINA | $960 | — | $960 | 0.43% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NORTH CAROLINA INC. | PO BOX 31817 CHARLOTTE, NC 282311817 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $11K | $5K | $15K | 15.94% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 12748 ROANOKE, VA 24028 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | — | $4K | 3.82% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NORTH CAROLINA INC. | PO BOX 31817 CHARLOTTE, NC 282311817 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $9K | $4K | $13K | 16.00% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 12748 ROANOKE, VA 24028 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | — | $3K | 3.87% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NORTH CAROLINA INC. | PO BOX 31817 CHARLOTTE, NC 282311817 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $7K | $3K | $10K | 15.73% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 12748 ROANOKE, VA 24028 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | — | $3K | 3.84% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NORTH CAROLINA INC. | PO BOX 31817 CHARLOTTE, NC 282311817 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $5K | $2K | $8K | 15.98% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 12748 ROANOKE, VA 24028 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 3.98% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NORTH CAROLINA INC. | PO BOX 31817 CHARLOTTE, NC 282311817 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $426 | $198 | $624 | 19.76% |
| MARSH & MCLENNAN AGENCY LLC3 | PO BOX 12748 ROANOKE, VA 24028 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $47 | — | $47 | 1.49% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH INSURANCE COMPANY EIN 59-1031071 CLAIM ADMINISTRATION | Contract Administrator; Direct payment from the plan; Claims processing; Other services; Participant communication; Named fiduciary; Non-monetary compensation; Float revenue Service code 12 | PO BOX 182223 CHATTANOOGA, TN 37422 | $380K |
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 | 801 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 801 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF NORTH CAROLINA | 625 | $223K |
| Life insurance(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 801 | $161K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 269 | $49K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 688 | $81K |
| Other(3 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 801 | $645K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 801 | — |
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.