| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NORTH CAROLINA, INC. | 214 NORTH TRYON STREET CHARLOTTE, NC 28282 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $38K | — | $38K | 10.78% |
| SEE ATTACHED LIST3 | — | AFLAC | $10K | $74 | $10K | 14.01% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NORTH CAROLINA, INC. | PO BOX 31817 CHARLOTTE, NC 28231 | EYEMED VISION CARE | $7K | — | $7K | 11.43% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NORTH CAROLINA, INC. | HEARST TOWER 214 NORTH TRYON ST CHARLOTTE, NC 28282 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | — | $4K | 7.23% |
| BARBARA ANN MEYER3 Filed as: BARBARA MEYER | 6 HICKORY LANE LEVITTOWN, NY 11756 | AFLAC | $32 | — | $32 | 10.00% |
| CROWN RISK MANAGEMENT, LLC3 Filed as: RUHLE RISK MANAGEMENT/PATRICK RUHLE | 200 GARDEN CITY PLAZA, SUITE 410 GARDEN CITY, NY 11530 | AFLAC | $6 | — | $6 | 1.88% |
| SAL RESTIVO INSURANCE BROKERAGE COR3 Filed as: SAL RESTIVO INUSURANCE BROKERAGE | 32 HASKEL LANE STONYBROOK, NY 11790 | AFLAC | $1 | — | $1 | 0.31% |
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 | 1,345 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,352 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF KANSAS, INC. | 914 | $261K |
| Vision | EYEMED VISION CARE | 1,898 | $59K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,345 | $349K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,345 | $199K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,345 | $199K |
| Other(4 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,345 | $471K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,898 | — |
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.