| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | 2100 ROSS AVENUE, SUITE 1200 DALLAS, TX 75201 | HCC LIFE INSURANCE COMPANY | $67K | — | $67K | 4.00% |
| LOCKTON COMPANIES, LLC3 | 717 NORTH HARDWOOD, SUITE 2500 DALLAS, TX 75201 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | — | $20K | $20K | 2.25% |
| LOCKTON COMPANIES, LLC3 | 717 NORTH HARDWOOD, SUITE 2500 DALLAS, TX 75201 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | — | $6K | $6K | 1.61% |
| GREG I HINRICHS3 Filed as: GREG HINRICHS | SOUTH PARK TOWERS 6000 FAIRVIEW ROAD, SUITE 400 CHARLOTTE, NC 28210 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $10K | $6K | $16K | 11.61% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $9K | — | $9K | 6.50% |
| LOCKTON COMPANIES, LLC3 | P.O. BOX 843844 KANSAS CITY, MO 64184 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $2K | $5K | 3.41% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC. | 200 GALLERIA PARKWAY, SUITE 1950 ATLANTA, GA 30339 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $237 | — | $237 | 0.17% |
| MARSHALL G RIGGINS3 Filed as: MARSHALL RIGGINS | 1010 N. ELM STREET GREENSBORO, NC 27401 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $49 | — | $49 | 0.04% |
| GREG I HINRICHS3 Filed as: GREG HINRICHS | SOUTH PARK TOWERS 6000 FAIRVIEW ROAD, SUITE 400 CHARLOTTE, NC 28210 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $897 | $609 | $2K | 23.62% |
| LOCKTON COMPANIES, LLC3 | P.O. BOX 843844 KANSAS CITY, MO 64184 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $186 | $196 | $382 | 5.99% |
| MARSHALL G RIGGINS3 Filed as: MARSHALL RIGGINS | 1010 N. ELM STREET GREENSBORO, NC 27401 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $6 | — | $6 | 0.09% |
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 | 3,411 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 34 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 203 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 3,648 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 3,791 | $903K |
| Long-term disability | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 3,791 | $400K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 3,321 | $1.7M |
| Other(4 contracts, 2 carriers) | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 3,791 | $1.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,791 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.