| 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 | $32K | $34 | $32K | 4.99% |
| 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 | — | $11K | $11K | 1.73% |
| 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 | — | $7K | $7K | 1.73% |
| 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 | $29K | — | $29K | 19.27% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST, INC | 1120 S. TRYON ST. #650 CHARLOTTE, NC 28203 | AMERITAS LIFE INSURANCE COMPANY | $12K | — | $12K | 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 | — | $1K | $1K | 1.11% |
| AFFINITY LTC, LLC3 | 6201 PRESIDENTIAL COURT FORT MYERS, FL 33919 | GENWORTH LIFE INSURANCE COMPANY | $10K | — | $10K | 10.96% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST INC | 29754 NETWORK PLACE CHICAGO, IL 606731297 | GENWORTH LIFE INSURANCE COMPANY | $3K | — | $3K | 2.86% |
| GREG I HINRICHS3 Filed as: GREG I. HINRICHS | 11525 N. COMMUNITY HOUSE RD STE 450 CHARLOTTE, NC 28277 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $974 | $4K | $5K | 11.51% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST, INC | PO BOX 905554 CHARLOTTE, NC 28290 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $755 | $734 | $1K | 3.57% |
| DANIEL WARD RICHARDSON3 | 11525 N. COMMUNITY HOUSE RD STE 450 CHARLOTTE, NC 28277 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 2.44% |
| JAMES WILLIAM DEUINK3 Filed as: JAMES WILLIAMS DEUINK | 11525 N. COMMUNITY HOUSE RD CHARLOTTE, NC 28277 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $974 | — | $974 | 2.33% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST, INC | 29754 NETWORK PLACE CHICAGO, IL 606731297 | METLIFE LEGAL PLANS | $2K | $278 | $2K | 10.48% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST INC | PO BOX 905554 CHARLOTTE, NC 28290 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $252 | $3K | 24.36% |
| JENNIFER J DUNN3 | 214 NORTH TRYON ST. STE 2500 CHARLOTTE, NC 78202 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $55 | — | $55 | 0.52% |
| DANIEL WARD RICHARDSON3 | 11525 N COMMUNITY HOUSE RD STE 450 CHARLOTTE, NC 28277 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $44 | — | $44 | 0.41% |
| JAMES WILLIAM DEUINK3 | 11525 N COMMUNITY HOUSE RD STE 450 CHARLOTTE, NC 28277 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $42 | — | $42 | 0.39% |
| GREG I HINRICHS3 | 11525 N COMMUNITY HOUSE RD STE 450 CHARLOTTE, NC 28277 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $42 | — | $42 | 0.39% |
| 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 |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF NORTH CAR EIN 56-0894904 CLAIMS PROCESSOR | Claims processing; Insurance agents and brokers Service code 12 | — | $427K |
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 | 780 | 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) | 794 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 1,382 | $648K |
| Vision | AMERITAS LIFE INSURANCE COMPANY | 1,401 | $119K |
| Life insurance | PRUDENTIAL LIFE INSURANCE COMPANY OF AMERICA | 909 | $401K |
| Long-term disability | PRUDENTIAL LIFE INSURANCE COMPANY OF AMERICA | 909 | $401K |
| Other(8 contracts, 7 carriers) | PRUDENTIAL LIFE INSURANCE COMPANY OF AMERICA | 974 | $749K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,401 | — |
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.