| 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 | — | $40K | $40K | 2.06% |
| 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 | 1.63% |
| 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 | 1.64% |
| GREG I HINRICHS3 | STE 125 11111 CARMEL COMMONS BLVD CHARLOTTE, NC 28226 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $13K | $8K | $20K | 10.73% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS -CHARLOTTE | 4565 PAYSPHERE CIR CHICAGO, IL 60674 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $7K | — | $7K | 3.89% |
| LOCKTON COMPANIES, LLC3 | C/O COMMERCE BANK, PO BOX 843844 KANSAS CITY, MO 64184 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $4K | — | $4K | 1.93% |
| DANIEL WARD RICHARDSON3 | STE 125 11111 CARMEL COMMONS BLVD CHARLOTTE, NC 28226 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $952 | — | $952 | 0.51% |
| JAMES WILLIAM DEUINK3 | STE 125 11111 CARMEL COMMONS BLVD CHARLOTTE, NC 28226 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $924 | — | $924 | 0.49% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC. | 200 GALLERIA PKWY STE 1950 ATLANTA, GA 30339 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $258 | — | $258 | 0.14% |
| MARSHALL G RIGGINS3 | 1010 N ELM ST GREENSBORO, NC 27401 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $22 | — | $22 | 0.01% |
| GREG I HINRICHS3 Filed as: GREG HINRICHS | 11111 CARMEL COMMONS BLVD STE 125 CHARLOTTE, NC 28226 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $2K | $2K | 5.55% |
| LOCKTON COMPANIES, LLC3 | PO BOX 843844 C/O COMMERCE BANK KANSAS CITY, MO 64184 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 4.58% |
| DANIEL WARD RICHARDSON3 | STE 125 11111 CARMEL COMMONS BLVD CHARLOTTE, NC 28226 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $177 | — | $177 | 0.44% |
| JAMES WILLIAM DEUINK3 | STE 125 11111 CARMEL COMMONS BLVD CHARLOTTE, NC 28226 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $171 | — | $171 | 0.42% |
| GREG I HINRICHS3 Filed as: GREG HINRICHS | 11111 CARMEL COMMONS BLVD STE 125 CHARLOTTE, NC 28226 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $4K | $6K | 23.18% |
| DANIEL WARD RICHARDSON3 | STE 125 11111 CARMEL COMMONS BLVD CHARLOTTE, NC 28226 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 7.12% |
| JAMES WILLIAM DEUINK3 | STE 125 11111 CARMEL COMMONS BLVD CHARLOTTE, NC 28226 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 6.91% |
| GREG I HINRICHS3 Filed as: GREG HINRICHS | 11111 CARMEL COMMONS BLVD STE 125 CHARLOTTE, NC 28226 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $830 | $2K | $3K | 20.01% |
| DANIEL WARD RICHARDSON3 | STE 125 11111 CARMEL COMMONS BLVD CHARLOTTE, NC 22826 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $898 | — | $898 | 6.76% |
| JAMES WILLIAM DEUINK3 | STE 125 11111 CARMEL COMMONS BLVD CHARLOTTE, NC 28226 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $871 | — | $871 | 6.55% |
| GREG I HINRICHS3 Filed as: GREG HINRICHS | 11111 CARMEL COMMONS BLVD STE 125 CHARLOTTE, NC 28226 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $810 | $706 | $2K | 16.92% |
| DANIEL WARD RICHARDSON3 | STE 125 11111 CARMEL COMMONS BLVD CHARLOTTE, NC 28226 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $434 | — | $434 | 4.84% |
| JAMES WILLIAM DEUINK3 | STE 125 11111 CARMEL COMMONS BLVD CHARLOTTE, NC 28226 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $422 | — | $422 | 4.71% |
| LOCKTON COMPANIES, LLC3 | PO BOX 843844 C/O COMMERCE BANK KANSAS CITY, MO 64184 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $30 | — | $30 | 0.33% |
| GREG I HINRICHS3 Filed as: GREG HINRICHS | 11111 CARMEL COMMONS BLVD STE 125 CHARLOTTE, NC 28226 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $71 | $94 | $165 | 16.39% |
| DANIEL WARD RICHARDSON3 | STE 125 11111 CARMEL COMMONS BLVD CHARLOTTE, NC 28226 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $73 | $4 | $77 | 7.65% |
| JAMES WILLIAM DEUINK3 | STE 125 11111 CARMEL COMMONS BLVD CHARLOTTE, NC 28226 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $71 | $4 | $75 | 7.45% |
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 | 4,240 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 40 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 81 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 4,361 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 4,240 | $1.0M |
| Long-term disability | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 4,240 | $503K |
| Stop-loss / reinsurancereinsurance | SYMETRA LIFE INSURANCE COMPANY | 3,726 | $1.9M |
| Other(8 contracts, 2 carriers) | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 4,240 | $1.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,240 | — |
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.