| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON US | 200 LIBERTY ST FI6 NEW YORK, NY 10281 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $30K | $30K | 1.59% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON US | 200 LIBERTY ST FI6 NEW YORK, NY 10281 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $14K | $14K | 1.58% |
| HINRICHS, GREG, I3 Filed as: HINRICHS, GREG I | STE 450 11525 N COMMUNITY HOUSE RD CHARLOTTE, NC 28277 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $3K | $6K | 6.55% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST, INC | ONE WORLD FINANCIAL CTR 6TH FL 200 LIBERTY ST NEW YORK, NY 10281 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $2K | $6K | 5.94% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST,INC. | WILLIS TOWER 35371 NETWORK PLACE CHICAGO, IL 60673 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $120 | $2K | 1.82% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS -CHARLOTTE | 4565 PAYSPHERE CIR CHICAGO, IL 60674 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 1.19% |
| RICHARDSON, DANIEL, WARD3 Filed as: RICHARDSON, DANIEL WARD | STE 450 11525 N COMMUNITY HOUSE RD CHARLOTTE, NC 28277 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 1.10% |
| DEUINK, JAMES, WILLIAM3 Filed as: DEUINK, JAMES WILLIAM | STE 450 11525 N COMMUNITY HOUSE RD CHARLOTTE, NC 28277 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 1.07% |
| LOCKTON COMPANIES, LLC3 | KANSAS CITY SERIES C/O COMMERCE BANK, PO BOX 843844 KANSAS CITY, MO 641843844 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $593 | $229 | $822 | 0.85% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC. | 200 GALLERIA PKWY STE 1950 ATLANTA, GA 30339 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $99 | $119 | $218 | 0.22% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWER WATSON NORTHEAST, INC | ONE WORLD FINANCIAL CTR 6TH FL 200 LIBERTY ST NEW YORK, NY 10281 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $8K | $6K | $13K | 14.04% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC. | 35371 NETWORK PLACE WILLIS TOWER CHICAGO, IL 60673 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $5K | $842 | $6K | 5.92% |
| HINRICHS, GREG, I3 Filed as: HINRICHS, GREG I | 11525 N COMMUNITY HOUSE RD STE 450 CHARLOTTE, NC 28277 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $3K | $5K | 4.74% |
| RICHARDSON, DANIEL, WARD3 Filed as: RICHARDSON, DANIEL WARD | STE 450 11525 N COMMUNITY HOUSE RD CHARLOTTE, NC 28277 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 1.69% |
| DEUINK, JAMES, WILLIAM3 Filed as: DEUINK, JAMES WILLIAM | STE 450 11525 N COMMUNITY HOUSE RD CHARLOTTE, NC 28277 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 1.64% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 444 W. 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $14K | — | $14K | 15.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWER WATSON NORTHEAST, INC | ONE WORLD FINANCIAL CTR 6TH FL 200 LIBERTY ST NEW YORK, NY 10281 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $5K | $4K | $9K | 12.12% |
| HINRICHS, GREG, I3 Filed as: HINRICHS, GREG I | 11525 N COMMUNITY HOUSE RD STE 450 CHARLOTTE, NY 28277 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $2K | $4K | 5.38% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC. | 35371 NETWORK PLACE WILLIS TOWER CHICAGO, NY 60673 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $518 | $4K | 5.21% |
| RICHARDSON, DANIEL, WARD3 Filed as: RICHARDSON, DANIEL WARD | STE 450 11525 N COMMUNITY HOUSE RD CHARLOTTE, NY 28277 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 2.12% |
| DEUINK, JAMES, WILLIAM3 Filed as: DEUINK, JAMES WILLIAM | STE 450 11525 N COMMUNITY HOUSE RD CHARLOTTE, NY 28277 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 2.06% |
| HINRICHS, GREG, I3 Filed as: HINRICHS, GREG I | 11525 N COMMUNITY HOUSE RD STE 450 CHARLOTTE, NC 28277 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $1K | $3K | 10.48% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC. | ONE WORLD FINANCIAL CTR 6TH FL 200 LIBERTY ST NEW YORK, NY 10281 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $718 | $2K | 5.82% |
| LOCKTON COMPANIES, LLC3 | KANSAS CITY SERIES PO BOX 843844 C/O COMMERCE BANK KANSAS CITY, MO 641843844 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $614 | $179 | $793 | 2.54% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC. | 35371 NETWORK PLACE WILLIS TOWER CHICAGO, IL 60673 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $658 | $39 | $697 | 2.23% |
| RICHARDSON, DANIEL, WARD3 Filed as: RICHARDSON, DANIEL WARD | STE 450 11525 N COMMUNITY HOUSE RD CHARLOTTE, NC 28277 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $394 | — | $394 | 1.26% |
| DEUINK, JAMES, WILLIAM3 Filed as: DEUINK, JAMES WILLIAM | STE 450 11525 N COMMUNITY HOUSE RD CHARLOTTE, NC 28277 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $383 | — | $383 | 1.23% |
| LOCKTON COMPANIES, LLC3 | 444 W. 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | NATIONAL UNION FIRE INS. CO. OF PITTSBURGH, PA | $2K | — | $2K | 20.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWER WATSON NORTHEAST, INC | ONE WORLD FINANCIAL CTR 6TH FL 200 LIBERTY ST NEW YORK, NY 10281 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $1K | $850 | $2K | 26.45% |
| HINRICHS, GREG, I3 Filed as: HINRICHS, GREG I | STE 450 11525 N COMMUNITY HOUSE RD CHARLOTTE, NC 28277 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $60 | $316 | $376 | 4.98% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC. | 35371 NETWORK PLACE WILLIS TOWER CHICAGO, IL 60673 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $197 | $39 | $236 | 3.13% |
| RICHARDSON, DANIEL, WARD3 Filed as: RICHARDSON, DANIEL WARD | STE 450 11525 N COMMUNITY HOUSE RD CHARLOTTE, NC 28277 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $61 | — | $61 | 0.81% |
| DEUINK, JAMES, WILLIAM3 Filed as: DEUINK, JAMES WILLIAM | STE 450 11525 N COMMUNITY HOUSE RD CHARLOTTE, NC 28277 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $60 | — | $60 | 0.80% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST, INC | ONE WORLD FINANCIAL CTR 6TH FL 200 LIBERTY ST NEW YORK, NY 10281 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $1K | $881 | $2K | 28.30% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC. | 35371 NETWORK PLACE WILLIS TOWER CHICAGO, IL 60673 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $342 | $41 | $383 | 5.25% |
| HINRICHS, GREG, I3 Filed as: HINRICHS, GREG I | 11525 N COMMUNITY HOUSE RD STE 450 CHARLOTTE, NC 28277 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $79 | $968 | $1K | 35.24% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC. | 35371 NETWORK PLACE WILLIS TOWER CHICAGO, IL 60673 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $165 | $398 | $563 | 18.95% |
| RICHARDSON, DANIEL, WARD3 Filed as: RICHARDSON, DANIEL WARD | STE 450 11525 N COMMUNITY HOUSE RD CHARLOTTE, NC 28277 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $81 | — | $81 | 2.73% |
| DEUINK, JAMES, WILLIAM3 Filed as: DEUINK, JAMES WILLIAM | STE 450 11525 N COMMUNITY HOUSE RD CHARLOTTE, NC 28277 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $79 | — | $79 | 2.66% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWER WATSON NORTHEAST, INC | ONE WORLD FINANCIAL CTR 6TH FL 200 LIBERTY ST NEW YORK, NY 10281 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $54 | $25 | $79 | 2.66% |
| HINRICHS, GREG, I3 Filed as: HINRICHS, GREG I | 11525 N COMMUNITY HOUSE RD STE 450 CHARLOTTE, NC 28277 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $27 | $331 | $358 | 39.91% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC. | 35371 NETWORK PLACE WILLIS TOWER CHICAGO, IL 60673 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $33 | $61 | $94 | 10.48% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC. | ONE WORLD FINANCIAL CTR 6TH FL 200 LIBERTY ST NEW YORK, NY 10281 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $20 | $12 | $32 | 3.57% |
| RICHARDSON, DANIEL, WARD3 Filed as: RICHARDSON, DANIEL WARD | STE 450 11525 N COMMUNITY HOUSE RD CHARLOTTE, NC 28277 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $27 | — | $27 | 3.01% |
| DEUINK, JAMES, WILLIAM3 Filed as: DEUINK, JAMES WILLIAM | STE 450 11525 N COMMUNITY HOUSE RD CHARLOTTE, NC 28277 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $27 | — | $27 | 3.01% |
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 | 3,940 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 168 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 61 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 4,169 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 4,476 | $1.9M |
| Long-term disability | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 4,476 | $887K |
| Other(10 contracts, 4 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 4,837 | $423K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,837 | — |
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.