| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST, INC | 29754 NETWORK PL CHICAGO, IL 60673 | METROPOLITAN LIFE INSURANCE COMPANY | $25K | $28 | $25K | 4.24% |
| 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 | — | $9K | $9K | 1.58% |
| 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 | $40K | — | $40K | 10.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | PO BOX 101162 PASADENA, CA 911890001 | PRUDENTIAL LIFE INSURANCE COMPANY OF AMERICA | $9K | — | $9K | 2.16% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST, INC | 150 N. COLLEGE ST SUITE 3050 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 | 2.61% |
| AFFINITY LTC, LLC3 | 6201 PRESIDENTIAL COURT FORT MYERS, FL 33919 | GENWORTH LIFE INSURANCE COMPANY | $10K | — | $10K | 11.64% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST INC | 29754 NETWORK PLACE CHICAGO, IL 606731297 | GENWORTH LIFE INSURANCE COMPANY | $2K | — | $2K | 2.07% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST, INC | 214 N. TRYON ST STE 2500 CHARLOTTE, NC 28202 | RELIASTAR LIFE INSURANCE COMPANY | $9K | — | $9K | 14.75% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NORTH CAROLINA INC | 29754 NETWORK PL CHICAGO, IL 60673 | RELIASTAR LIFE INSURANCE COMPANY | $1K | — | $1K | 1.87% |
| GREG I HINRICHS3 Filed as: GREG I. HINRICHS | 11111 CARMEL COMMONS BLVD STE 125 CHARLOTTE, NC 28226 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $2K | $3K | 8.43% |
| DANIEL WARD RICHARDSON3 | 11111 CARMEL COMMONS BLVD. STE 125 CHARLOTTE, NC 28226 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 3.30% |
| JAMES WILLIAM DEUINK3 | 11111 CARMEL COMMONS BLVD. STE 125 CHARLOTTE, NC 28226 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 3.16% |
| 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 | — | $2K | 7.08% |
| DAVID MASON DOKELL3 | 159 BEACON DRIVE MOORESVILLE, NC 28117 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $140 | $2K | 6.94% |
| AON CONSULTING INC3 Filed as: AON CONSULTING INC. | 29840 NETWORK PLACE CHICAGO, IL 60673 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $48 | — | $48 | 0.14% |
| 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 | — | $2K | 10.17% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF TENNESSEE, INC. | 29982 NETWORK PLACE CHICAGO, IL 60673 | METROPOLITAN PROPERTY AND CASUALTY INSURANCE COMPANY | — | $345 | $345 | 1.81% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF TENNESSEE, INC. | 265 BROOKVIEW CENTRE WAY SUITE 505 KNOXVILLE, TN 37919 | METROPOLITAN PROPERTY AND CASUALTY INSURANCE COMPANY | — | $28 | $28 | 0.15% |
| JENNIFER J DUNN3 | 214 N TRYON STREET SUITE 2500 CHARLOTTE, NC 28202 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $110 | — | $110 | 1.18% |
| DANIEL WARD RICHARDSON3 | 11111 CARMEL COMMONS BLVD SUITE 125 CHARLOTTE, NC 28226 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $88 | — | $88 | 0.95% |
| JAMES WILLIAM DEUINK3 | 11111 CARMEL COMMONS BLVD SUITE 125 CHARLOTTE, NC 28226 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $84 | — | $84 | 0.90% |
| GREG I HINRICHS3 | 11111 CARMEL COMMONS BLVD SUITE 125 CHARLOTTE, NC 28226 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $84 | — | $84 | 0.90% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST, INC | PO BOX 905554 CHARLOTTE, NC 28290 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $6 | — | $6 | 0.06% |
| GREG I HINRICHS3 Filed as: GREG I. HINRICHS | 11111 CARMEL COMMONS BLVD STE 125 CHARLOTTE, NC 28226 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $114 | $366 | $480 | 28.30% |
| DANIEL WARD RICHARDSON3 | 11111 CARMEL COMMONS BLVD STE 125 CHARLOTTE, NC 28226 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $119 | — | $119 | 7.02% |
| JAMES WILLIAM DEUINK3 | 11111 CARMEL COMMONS BLVD. STE 125 CHARLOTTE, NC 28226 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $114 | — | $114 | 6.72% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES, INC. EIN 41-1289245 CLAIMS PROCESSOR | Claims processing; Other services Service code 12 | — | $460K |
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 | 857 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 11 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 868 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 1,205 | $586K |
| Vision | AMERITAS LIFE INSURANCE COMPANY | 1,278 | $90K |
| Life insurance | PRUDENTIAL LIFE INSURANCE COMPANY OF AMERICA | 844 | $405K |
| Long-term disability | PRUDENTIAL LIFE INSURANCE COMPANY OF AMERICA | 844 | $405K |
| Other(10 contracts, 8 carriers) | PRUDENTIAL LIFE INSURANCE COMPANY OF AMERICA | 940 | $677K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,278 | — |
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.