| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NORTH CAROLINA | HEARST TOWER 214 N TRYON ST CHARLOTTE, NC 28282 | CIGNA GROUP INSURANCE | — | $12K | $12K | 1.55% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NORTH CAROLINA | HEARST TOWER 214 N TRYON ST CHARLOTTE, NC 28282 | CIGNA GROUP INSURANCE | — | $10K | $10K | 1.60% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NORTH CAROLINA, INC. | 214 N TRYON ST SUITE 2500 CHARLOTTE, NC 282022381 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $5K | $5K | 1.58% |
| MJ INSURANCE3 Filed as: VARIOUS AGENTS-LIST ATTACHED | — | AFLAC | $61K | $3K | $64K | 23.91% |
| MJ INSURANCE3 Filed as: VARIOUS AGENTS-ATTACHED LIST | PO BOX 1365 COLUMBIA, SC 292021365 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $22K | $452 | $22K | 12.61% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NORTH CAROLINA | HEARST TOWER 214 N TRYON ST CHARLOTTE, NC 28282 | CIGNA GROUP INSURANCE | — | $757 | $757 | 1.58% |
| WILLIAM R. GUYTHER4 | 1005 ROGOSIN BLVD LOWELL, NC 28098 | PREPAID LEGAL SERVICE DBA LEGALSHIELD | $1K | — | $1K | 4.66% |
| JOHN JOSEPH RODRIGUEZ4 | 15 HOOLET CT CANDLER, NC 28715 | PREPAID LEGAL SERVICE DBA LEGALSHIELD | $897 | — | $897 | 3.25% |
| SALUDA INSURANCE GROUP LLC4 | PO BOX 448 SALUDA, SC 29138 | PREPAID LEGAL SERVICE DBA LEGALSHIELD | $43 | — | $43 | 0.16% |
| JOHN J DADAK III4 | 17 BLACK WALNUT LN CANDLER, NC 28715 | PREPAID LEGAL SERVICE DBA LEGALSHIELD | $25 | — | $25 | 0.09% |
| ROBERT SHEESLEY4 | 40 PINE STREET RYE, NH 03870 | PREPAID LEGAL SERVICE DBA LEGALSHIELD | $22 | — | $22 | 0.08% |
| RICHARD T JAMES4 | 525 WINTERBERRY LN GASTONIA, NC 28056 | PREPAID LEGAL SERVICE DBA LEGALSHIELD | $17 | — | $17 | 0.06% |
| KRYSTAL J ROMPS4 | 130 PORTER ROAD ASHEVILLE, NC 28803 | PREPAID LEGAL SERVICE DBA LEGALSHIELD | $10 | — | $10 | 0.04% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD N CAROLINA EIN 56-0894904 CLAIMS ADMINISTRATOR | Insurance agents and brokers Service code 22 | — | $1.7M |
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 | 2,793 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 45 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,838 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 2,207 | $244K |
| Life insurance(3 contracts, 3 carriers) | CIGNA GROUP INSURANCE | 356 | $1.2M |
| Short-term disability(3 contracts, 3 carriers) | CIGNA GROUP INSURANCE | 356 | $1.1M |
| Long-term disability(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 231 | $511K |
| Other(5 contracts, 4 carriers) | CIGNA GROUP INSURANCE | 356 | $1.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,207 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.