| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST, INC | 214 N. TRYON ST STE 2500 CHARLOTTE, NC 28202 | METROPOLITAN LIFE INSURANCE COMPANY | $26K | $31 | $26K | 4.56% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF TENNESSEE INC | 26 CENTURY BLVD C/O JP MORGAN CHASE NASHVILLE, TN 372143685 | METROPOLITAN LIFE INSURANCE COMPANY | — | $7K | $7K | 1.14% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NORTH CAROLINA INC. | 214 N TRYON STREET SUITE 2500 CHARLOTTE, NC 28202 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | $31 | $5K | 0.85% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NORTH CAROLINA INC. | PO BOX 31817 CHARLOTTE, NC 282311817 | METROPOLITAN LIFE INSURANCE COMPANY | — | $4K | $4K | 0.71% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST | 240 NORTH TRYON STREET SUITE 2500 CHARLOTTE, NC 28282 | PRUDENTIAL LIFE INSURANCE COMPANY OF AMERICA | $39K | — | $39K | 10.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SERVICES OF CA | LOCKBOX 100485 PASADENA, CA 911890485 | PRUDENTIAL LIFE INSURANCE COMPANY OF AMERICA | $8K | — | $8K | 2.10% |
| AFFINITY LTC, LLC3 | 6201 PRESIDENTIAL COURT FORT MYERS, FL 33919 | GENWORTH LIFE INSURANCE COMPANY | $8K | — | $8K | 9.34% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST INC | 29754 NETWORK PLACE CHICAGO, IL 606731297 | GENWORTH LIFE INSURANCE COMPANY | $1K | — | $1K | 1.67% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NORTH CAROLINA, INC | 29754 NETWORK PLACE CHICAGO, ID 606731297 | GENWORTH LIFE INSURANCE COMPANY | $455 | — | $455 | 0.51% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST, INC | 214 N TRYON STREET SUITE 2500 CHARLOTTE, NC 28202 | AMERITAS LIFE INSURANCE COMPANY | $9K | — | $9K | 10.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NORTH CAROLINA, INC | 214 N. TRYON ST STE 2500 CHARLOTTE, NC 28202 | AMERITAS LIFE INSURANCE COMPANY | — | $2K | $2K | 1.82% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NORTH CAROLINA INC | 29754 NETWORK PL CHICAGO, IL 60673 | RELIASTAR LIFE INSURANCE COMPANY | $8K | — | $8K | 16.47% |
| DAVID MASON DOKELL3 | 159 BEACON DRIVE MOORESVILLE, NC 28117 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $416 | $3K | 8.67% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST INC. | 214 N TRYON ST. STE 2500 CHARLOTTE, NC 28202 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $753 | $2K | 6.34% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NORTH CAROLINA INC. | 214 N TRYON STREET SUITE 2500 CHARLOTTE, NC 28202 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 4.12% |
| AON CONSULTING INC3 Filed as: AON CONSULTING INC. | 29840 NETWORK PLACE CHICAGO, IL 60673 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $69 | — | $69 | 0.18% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST, INC | 214 N TRYON STREET SUITE 2500 CHARLOTTE, NC 28202 | METROPOLITAN PROPERTY AND CASUALTY INSURANCE COMPANY | $2K | $325 | $2K | 11.61% |
| JENNIFER J DUNN3 | 214 N TRYON STREET SUITE 2500 CHARLOTTE, NC 28202 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $112 | — | $112 | 1.25% |
| DANIEL WARD RICHARDSON3 | 11111 CARMEL COMMONS BLVD SUITE 125 CHARLOTTE, NC 28226 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $90 | — | $90 | 1.01% |
| JAMES WILLIAM DEUINK3 | 11111 CARMEL COMMONS BLVD SUITE 125 CHARLOTTE, NC 28226 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $86 | — | $86 | 0.96% |
| GREG I HINRICHS3 | 11111 CARMEL COMMONS BLVD SUITE 125 CHARLOTTE, NC 28226 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $86 | — | $86 | 0.96% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST, INC | PO BOX 905554 CHARLOTTE, NC 28290 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $7 | — | $7 | 0.08% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST, INC | 200 LIBERTY STREET NEW YORK, NY 10281 | FEDERAL INSURANCE COMPANY | $1K | — | $1K | 25.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES, INC. EIN 41-1289245 CLAIMS PROCESSOR | Other services; Claims processing Service code 12 | — | $518K |
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 | 889 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 14 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 903 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 1,304 | $579K |
| Vision | AMERITAS LIFE INSURANCE COMPANY | 1,293 | $88K |
| Life insurance | PRUDENTIAL LIFE INSURANCE COMPANY OF AMERICA | 889 | $392K |
| Long-term disability | PRUDENTIAL LIFE INSURANCE COMPANY OF AMERICA | 889 | $392K |
| Other(8 contracts, 8 carriers) | PRUDENTIAL LIFE INSURANCE COMPANY OF AMERICA | 980 | $621K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,304 | — |
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.