| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC. | 200 LIBERTY STREET, FL. 6 NEW YORK, NY 10281 | UNITEDHEALTHCARE INSURANCE COMPANY | $11K | $44K | $54K | 2.47% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL GREENSBORO | 333 N. GREENE ST STE 101 GREENSBORO, NC 27401 | UNITEDHEALTHCARE INSURANCE COMPANY | $119 | $16K | $16K | 0.74% |
| BANYAN CONSULTING GROUP INC3 Filed as: BANYAN CONSULTING GROUP INC. | 333 N. GREENE ST STE 101 GREENSBORO, NC 27401 | UNITEDHEALTHCARE INSURANCE COMPANY | — | $16 | $16 | 0.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK INC. | PO BOX 4557 NEW YORK, NY 10249 | UNITEDHEALTHCARE INSURANCE COMPANY | $10K | — | $10K | 14.13% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC. | 199 SCOTT ST, STE 800 BUFFALO, NY 14204 | PRINCIPAL LIFE INSURANCE COMPANY | $1K | — | $1K | 3.89% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 333 N. GREENE ST STE 101 GREENSBORO, NC 27401 | PRINCIPAL LIFE INSURANCE COMPANY | $1K | — | $1K | 2.96% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL LIMITED | 300 N. LASALLE ST, 17TH FLOOR CHICAGO, IL 60654 | PRINCIPAL LIFE INSURANCE COMPANY | — | $475 | $475 | 1.31% |
| MOSAIC GROUP SERVICES3 | PO BOX 2291 DURHAM, NC 27702 | USABLE LIFE | $2K | — | $2K | 5.00% |
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 | 219 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 224 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 838 | $2.2M |
| Dental(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 838 | $2.2M |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 838 | $2.2M |
| Life insurance(3 contracts, 3 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 219 | $141K |
| Short-term disability(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 219 | $105K |
| Long-term disability(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 219 | $105K |
| Other(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 219 | $105K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 838 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.