| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SE | 29754 NETWORK PLACE CHICAGO, IL 60673 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $38K | $38K | 1.50% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES LLC | PO BOX 896620 CHARLOTTE, NC 28289 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $25K | $25K | 1.00% |
| MCGRIFF INSURANCE SERVICES INC3 | PO BOX 896620 CHARLOTTE, NC 28289 | DELTA DENTAL OF NORTH CAROLINA | $5K | — | $5K | 3.92% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SE | PO BOX 905643 CHARLOTTE, NC 28290 | DELTA DENTAL OF NORTH CAROLINA | $4K | — | $4K | 2.66% |
| MCGRIFF INSURANCE SERVICES INC3 | PO BOX 896620 CHARLOTTE, NC 28289 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | — | $6K | 5.34% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SE | 29754 NETWORK PLACE CHICAGO, IL 60673 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | — | $5K | 4.65% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SERVICES | PO BOX 101162 PASADENA, CA 91189 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $2K | $2K | 1.47% |
| MCGRIFF INSURANCE SERVICES INC3 | 12725 MORRIS RD EXT BLDG 100, STE 200 ALPHARETTA, GA 30004 | AXIS INSURANCE COMPANY | $6K | — | $6K | 9.52% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SE | 214 N TRYON STREET STE 2500 CHARLOTTE, NC 28202 | AXIS INSURANCE COMPANY | $1K | — | $1K | 2.32% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES | PO BOX 896620 CHARLOTTE, NC 28289 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 8.85% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SE | 29754 NETWORK PLACE CHICAGO, IL 60673 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 6.15% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SERVICES | PO BOX 101162 PASADENA, CA 91189 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $648 | $648 | 1.70% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SE | 29754 NETWORK PLACE CHICAGO, IL 60673 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $2K | — | $2K | 5.19% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES LLC | PO BOX 896620 CHARLOTTE, NC 28289 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $2K | — | $2K | 4.81% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES | PO BOX 896620 CHARLOTTE, NC 28289 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 11.44% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SE | 29754 NETWORK PLACE CHICAGO, IL 60673 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 8.56% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SERVICES | PO BOX 101162 PASADENA, CA 91189 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $434 | $434 | 1.71% |
| MCGRIFF INSURANCE SERVICES INC3 | PO BOX 896620 CHARLOTTE, NC 28289 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 8.90% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SE | 29754 NETWORK PLACE CHICAGO, IL 60673 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 6.10% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SERVICES | PO BOX 101162 PASADENA, CA 91189 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $402 | $402 | 1.66% |
| MCGRIFF INSURANCE SERVICES INC3 | PO BOX 896620 CHARLOTTE, NC 28289 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $967 | — | $967 | 5.34% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SE | 29754 NETWORK PLACE CHICAGO, IL 60673 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $842 | — | $842 | 4.65% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SERVICES | PO BOX 101162 PASADENA, CA 91189 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $78 | $78 | 0.43% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES | PO BOX 896620 CHARLOTTE, NC 28289 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $233 | — | $233 | 11.48% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SE | 29754 NETWORK PLACE CHICAGO, IL 60673 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $173 | — | $173 | 8.53% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SERVICES | PO BOX 101162 PASADENA, CA 91189 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $57 | $57 | 2.81% |
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 | 198 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 204 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 289 | $2.6M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF NORTH CAROLINA | 398 | $192K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 273 | $34K |
| Life insurance(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 198 | $141K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 198 | $38K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 198 | $24K |
| Prescription drug(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 289 | $2.6M |
| Other(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 198 | $20K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 398 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.