| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NORTH CAROLINA INC | 214 N TRYTON ST SUITE 25000 CHARLOTTE, NC 28202 | UNITED HEALTHCARE INSURANCE COMPANY | — | $25K | $25K | 3.09% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NORTH CAROLINA INC | 301 S TRYTON ST SUITE 2600 CHARLOTTE, NC 28282 | USABLE LIFE | $10K | — | $10K | 10.78% |
| MOSAIC GROUP SERVICES3 | PO BOX 2291 DURHAM, NC 27702 | USABLE LIFE | $5K | — | $5K | 5.78% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NORTH CAROLINA INC | 214 N TRYTON ST SUITE 2500 CHARLOTTE, NC 28202 | UNITED HEALTHCARE OF THE RIVER VALLEY INC | — | $2K | $2K | 3.09% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NORTH CAROLINA INC | 214 N TRYTON ST SUITE 2500 CHARLOTEE, NC 28202 | NATIONAL GUARDIAN LIFE - ALWAYS CARE | $3K | — | $3K | 4.54% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NORTH CAROLINA INC | 301 S TRYTON ST SUITE 2600 CHARLOTTE, NC 28282 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY - VISION | $1K | — | $1K | 210.44% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| FLORES AND ASSOCIATES EIN 56-1542307 HRA CLAIMS ADMIN | Contract Administrator; Claims processing Service code 12 | — | $5K |
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 | 145 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 145 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 181 | $867K |
| Dental | NATIONAL GUARDIAN LIFE - ALWAYS CARE | 132 | $67K |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY - VISION | 205 | $680 |
| Life insurance | USABLE LIFE | 143 | $93K |
| Short-term disability | USABLE LIFE | 143 | $93K |
| Long-term disability | USABLE LIFE | 143 | $93K |
| Other | USABLE LIFE | 143 | $93K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 205 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.