| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JENNIFER J DUNN3 Filed as: JENNIFER J. DUNN | 17109 FRESHWATER LANE CORNELIUS, NC 28031 | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | $86K | — | $86K | 2.16% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST INC. | 240 NORTH TRYON STREET SUITE 2500 CHARLOTTE, NC 28282 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $35K | — | $35K | 11.75% |
| IMG3 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $96 | $96 | 0.03% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST | — | DELTA DENTAL OF NORTH CAROLINA | $25K | — | $25K | 9.09% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON | 29727 NETWORK PLACE CHICAGO, IL 606731297 | EYEMED VISION CARE / FIDELITY SECURITY LIFE INSURANCE COMPANY | $5K | — | $5K | 9.20% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST, INC | 29982 NETWORK PLAZA CHICAGO, IL 60673 | LEGALPLANS, USA | $1K | — | $1K | 14.99% |
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 | 476 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 480 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 654 | $4.0M |
| Dental | DELTA DENTAL OF NORTH CAROLINA | 659 | $279K |
| Vision | EYEMED VISION CARE / FIDELITY SECURITY LIFE INSURANCE COMPANY | 536 | $58K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 476 | $296K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 476 | $296K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 476 | $296K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 654 | $4.0M |
| Other(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 476 | $305K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 659 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.