| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST | PO BOX 13784 NEWARK, NJ 07188 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $9K | — | $9K | 1.49% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST | 29754 NETWORK PL. CHICAGO, IL 60673 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $9K | — | $9K | 1.48% |
| WILLIS TOWERS WATSON US LLC3 | PO BOX 28852 LOCKBOX 28852 NEW YORK, NY 10087 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | — | $429 | $429 | 0.07% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST, INC | 1120 S. TRYON ST STE 550 CHARLOTTE, NC 28203 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $15K | — | $15K | 5.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC. | 233 S. WACKER DR. STE 1800 CHICAGO, IL 60606 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $4K | $4K | 1.47% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST, INC | 1120 S. TRYON ST. STE 550 CHARLOTTE, NC 20203 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $14K | — | $14K | 5.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC. | 233 S. WACKER DR. STE 1800 CHICAGO, IL 60606 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $5K | $5K | 1.63% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST, INC | 1120 S. TRYON ST. STE 550 CHARLOTTE, NC 28203 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $21K | — | $21K | 10.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC | 233 S. WACKER DR. STE 1800 CHICAGO, IL 60606 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $4K | $4K | 1.80% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST, INC | 214 N TRYON ST SUITE 2500 CHARLOTTE, NC 282022381 | UNUM INSURANCE COMPANY | $22K | $1K | $23K | 21.25% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLS TOWERS WATSON SOUTHEAST | PO BOX 905554 CHARLOTTE, NC 28290 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $12K | $1K | $13K | 16.08% |
| PLANSOURCE BENEFITS ADMINISTRATION3 Filed as: PLANSOURCE BENEFITS ADMIN INC | P. O. BOX 1313 ORLANDO, FL 32802 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $18 | — | $18 | 0.02% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NORTH CAROLINA INC | 29754 NETWORK PLACE CHICAGO, IL 606731297 | VISION SERVICE PLAN | $4K | — | $4K | 5.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST, INC | 29754 NETWORK PLACE CHICAGO, IL 606731297 | METROPOLITAN GENERAL INSURANCE COMPANY | $3K | $33 | $3K | 10.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF TENNESSEE, INC. | 29982 NETWORK PLACE CHICAGO, IL 60673 | METROPOLITAN GENERAL INSURANCE COMPANY | — | $421 | $421 | 1.40% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD PLAN OF GEOR EIN 58-1638390 ADMINISTRATOR | Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Contract Administrator; Other services; Claims processing Service code 12 | — | $702K |
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 | 1,047 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 11 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,058 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 828 | $600K |
| Vision | VISION SERVICE PLAN | 806 | $82K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 1,078 | $304K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 1,078 | $276K |
| Other(5 contracts, 4 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 1,078 | $734K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,078 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.