| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC Filed as: WILLIS OF NORTH CAROLINA, INC. | 214 NORTH TRYON STREET CHARLOTTE, NC 28282 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $39K | — | $39K | 5.00% |
| 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 | $15K | $5K | $20K | 4.70% |
| 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 | $13K | $4K | $18K | 4.69% |
| 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 | $9K | $3K | $12K | 4.68% |
| 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 | $728 | $247 | $975 | 4.69% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA EIN 59-1031071 | Other services; Float revenue; Contract Administrator; Named fiduciary; Non-monetary compensation; Claims processing; Participant communication; Direct payment from the plan Service code 12 | 11016 RUSHMORE DRIVE SUITE 300 CHARLOTTE, NC 28277 | $889K |
| WILLIS OF NORTH CAROLINA, INC. EIN 56-1671375 | Consulting (general) Service code 16 | PO BOX 31817 CHARLOTTE, NC 28282 | $40K |
| 1-800MD EIN 27-1532190 | Contract Administrator Service code 13 | 6408 BANNINGTON ROAD CHARLOTTE, NC 28226 | $25K |
| CORPORATE CHAPLAINS OF AMERICA EIN 56-1966466 | Contract Administrator Service code 13 | PO BOX 63107 CHARLOTTE, NC 28263 | $20K |
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 | 1,773 | Currently employed and enrolled or eligible. |
| Retired/separated still eligible | 14 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,787 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,671 | $786K |
| Vision | VISION SERVICE PLAN | 1,790 | $266K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 3,000 | $418K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,041 | $264K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 978 | $377K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,658 | $21K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,000 | — |
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."
No prospect flags tripped on this filing.