| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NORTH CAROLINA, INC. | 241 NORTH TRYON STREET SUITE 2500 CHARLOTTE, NC 28282 | KAISER PERMANENTE | $55K | — | $55K | 4.32% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NORTH CAROLINA | 214 NORTH TRYON STREET SUITE 2500 CHARLOTTE, NC 28231 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | — | $1K | $1K | 1.35% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD SO CAROLINA EIN 57-0287419 CLAIMS ADMIN | Insurance agents and brokers; Other commissions; Claims processing; Contract Administrator; Other fees Service code 12 | — | $687K |
| WILLIS OF NORTH CAROLINA BROKER | Insurance agents and brokers; Other commissions Service code 22 | 214 N TRYON STREET SUITE 2500 CHARLOTTE, NC 282311817 | $60K |
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 | 1,357 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 19 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,376 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER PERMANENTE | 227 | $1.3M |
| Dental(2 contracts, 2 carriers) | KAISER PERMANENTE | 1,337 | $1.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,337 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.