| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | SYMETRA LIFE INSURANCE COMPANY | $0 | $51K | $51K | 2.95% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | — | $17K | $17K | 1.84% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | — | $8K | $8K | 1.84% |
| GREG I HINRICHS3 Filed as: GREG HINRICHS | 11111 CARMEL COMMONS BLVD STE 125 CHARLOTTE, NC 28226 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $13K | $5K | $18K | 8.88% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRLCE CHICAGO, IL 60674 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $8K | — | $8K | 3.93% |
| LOCKTON COMPANIES, LLC3 | PO BOX 843844 KANSAS CITY, MO 64184 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $327 | $5K | 2.30% |
| DANIEL WARD RICHARDSON3 | STE 125 11111 CARMEL COMMONS BLVD CHARLOTTE, NC 28226 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $509 | — | $509 | 0.25% |
| JAMES WILLIAM DEUINK3 Filed as: JAMES WILLIAM DEUNIK | STE 125 11111 CARMEL COMMONS BLVD CHARLOTTE, NC 28226 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $494 | — | $494 | 0.25% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC. | 200 GALLERIA PKWY STE 1950 ATLANTA, GA 30339 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $269 | — | $269 | 0.13% |
| LOCKTON COMPANIES, LLC3 | 444 W 47TH ST STE 900 KANSAS CITY, MO 64112 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $44 | $44 | 0.02% |
| MARSHALL G RIGGINS3 Filed as: MARSHALL RIGGINS | 1010 N ELM ST GREENSBORO, NC 27401 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $42 | $0 | $42 | 0.02% |
| GREG I HINRICHS3 Filed as: GREG HINRICHS | 11111 CARMEL COMMONS BLVD STE 125 CHARLOTTE, NC 28226 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $890 | $5K | 11.22% |
| LOCKTON COMPANIES, LLC3 | PO BOX 843844 KANSAS CITY, MO 64184 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 4.77% |
| DANIEL WARD RICHARDSON3 | STE 125 11111 CARMEL COMMONS BLVD CHARLOTTE, NC 28226 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $106 | — | $106 | 0.25% |
| JAMES WILLIAM DEUINK3 | STE 125 11111 CARMEL COMMONS BLVD CHARLOTTE, NC 28226 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $103 | — | $103 | 0.24% |
| LOCKTON COMPANIES, LLC3 | 444 W 47TH ST STE 900 KANSAS CITY, MO 64112 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $49 | $49 | 0.11% |
| GREG I HINRICHS3 Filed as: GREG HINRICHS | 11111 CARMEL COMMONS BLVD STE 125 CHARLOTTE, NC 28226 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $4K | $5K | 29.97% |
| DANIEL WARD RICHARDSON3 | STE 125 11111 CARMEL COMMONS BLVD CHARLOTTE, NC 28226 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 7.97% |
| JAMES WILLIAM DEUINK3 | STE 125 11111 CARMEL COMMONS BLVD CHARLOTTE, NC 28226 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 7.73% |
| GREG I HINRICHS3 Filed as: GREG HINRICHS | 11111 CARMEL COMMONS BLVD STE 125 CHARLOTTE, NC 28226 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $511 | $1K | $2K | 28.58% |
| DANIEL WARD RICHARDSON3 | STE 125 11111 CARMEL COMMONS BLVD CHARLOTTE, NC 22826 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $527 | — | $527 | 7.52% |
| JAMES WILLIAM DEUINK3 | STE 125 11111 CARMEL COMMONS BLVD CHARLOTTE, NC 28226 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $511 | — | $511 | 7.30% |
| GREG I HINRICHS3 Filed as: GREG HINRICHS | 11111 CARMEL COMMONS BLVD STE 125 CHARLOTTE, NC 28226 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $509 | $410 | $919 | 18.56% |
| DANIEL WARD RICHARDSON3 | STE 125 11111 CARMEL COMMONS BLVD CHARLOTTE, NC 28226 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $66 | — | $66 | 1.33% |
| JAMES WILLIAM DEUINK3 | STE 125 11111 CARMEL COMMONS BLVD CHARLOTTE, NC 28226 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $64 | — | $64 | 1.29% |
| LOCKTON COMPANIES, LLC3 | PO BOX 843844 KANSAS CITY, MO 64184 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $40 | $14 | $54 | 1.09% |
| GREG I HINRICHS3 Filed as: GREG HINRICHS | 11111 CARMEL COMMONS BLVD STE 125 CHARLOTTE, NC 28226 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $44 | $74 | $118 | 16.86% |
| DANIEL WARD RICHARDSON3 | STE 125 11111 CARMEL COMMONS BLVD CHARLOTTE, NC 28226 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $25 | — | $25 | 3.57% |
| JAMES WILLIAM DEUINK3 | STE 125 11111 CARMEL COMMONS BLVD CHARLOTTE, NC 28226 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $24 | — | $24 | 3.43% |
| LOCKTON COMPANIES, LLC3 | PO BOX 843844 KANSAS CITY, MO 64184 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $15 | — | $15 | 2.14% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC | COMMISSION LOCKBOX 28852 NEW YORK, NY 10087 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | — | $4 | $4 | 2.14% |
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 | 3,460 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 30 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 75 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 3,565 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 3,460 | $905K |
| Long-term disability | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 3,460 | $440K |
| Stop-loss / reinsurancereinsurance | SYMETRA LIFE INSURANCE COMPANY | 3,170 | $1.7M |
| Other(8 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 266 | $305K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,460 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.