| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DE INC. | LOCKBOX 28852 P.O. BOX 28852 NEW YORK, NY 10087 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $22K | $22K | 0.56% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON OF DELAWARE INC | COMMISSION LOCKBOX 28852 P.O. BOX 28852 NEW YORK, NY 100878852 | BERKLEY LIFE AND HEALTH INSURANCE COMPANY | — | $81K | $81K | 5.01% |
| WORKPLACE SOLUTIONS, INC.3 | 120-A GILLS CREEK PKWY COLUMBIA, SC 29209 | PROVIDENT LIFE AND ACCIDENT INSURANC COMPANY | $11K | $2K | $13K | 4.75% |
| DAVID BEAU BOUDREAUX3 | 120-A GILLS CREEED PKWY COLUMBIA, SC 29209 | PROVIDENT LIFE AND ACCIDENT INSURANC COMPANY | $138 | — | $138 | 0.05% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP INSURANCE SERVICES, INC. | BLDG 2, SUITE 125 1250 CAPITAL OF TEXAS HWY AUSTIN, TX 78746 | PROVIDENT LIFE AND ACCIDENT INSURANC COMPANY | $34 | — | $34 | 0.01% |
| GIBSON INSURANCE AGENCY, INC.3 | 130 SOUTH MAIN STREET SUITE 400 P.O. BOX 11177 SOUTH BEND, IN 46634 | PROVIDENT LIFE AND ACCIDENT INSURANC COMPANY | -$1K | $176 | -$1K | -0.37% |
| GREG I HINRICHS3 Filed as: GREG HINRICHS | SOUTHPARK TOWERS 6000 FAIRVIEW RD STE 400 CHARLOTTE, NC 28210 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $7K | $13K | $20K | 10.65% |
| DANIEL WARD RICHARDSON3 Filed as: DANIEL RICHARDSON | 6000 FAIRVIEW RD STE 400 CHARLOTTE, NC 28210 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $9K | $377 | $9K | 4.79% |
| JAMES WILLIAM DEUINK3 Filed as: JAMES DEUINK | 6000 FAIRVIEW RD STE 400 SOUTH PARK TOWERS CHARLOTTE, NC 28210 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $7K | — | $7K | 3.68% |
| IVAN HINRICHS3 | 6000 FAIRVIEW RD STE 400 CHARLOTTE, NC 28210 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $241 | $337 | $578 | 0.31% |
| GIBSON INSURANCE AGENCY, INC.3 | 130 SOUTH MAIN STREET SUITE 400 P.O. BOX 11177 SOUTH BEND, IN 46634 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $143 | $3K | 1.80% |
| WORKPLACE SOLUTIONS, INC.3 | 120-A GILLS CREEK PKWY COLUMBIA, SC 29209 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $409 | $2K | 1.07% |
| DAVID BEAU BOUDREAUX3 | 120-A GILLS CREEK PKWY COLUMBIA, SC 29209 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 0.83% |
| GIBSON INSURANCE AGENCY, INC.3 | 130 SOUTH MAIN STREET, SUITE 400 P.O. BOX 11177 SOUTH BEND, IN 46634 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $2 | $2K | 10.27% |
| GREG I HINRICHS3 Filed as: GREG HINRICHS | SOUTH PARK TOWERS 6000 FAIRVIEW ROAD SUITE 400 CHARLOTTE, NC 28210 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $870 | $2K | $3K | 14.80% |
| DANIEL WARD RICHARDSON3 Filed as: DANIEL RICHARDSON | 6000 FAIRVIEW ROAD SUITE 400 CHARLOTTE, NC 28210 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $19 | $1K | 5.18% |
| JAMES WILLIAM DEUINK3 Filed as: JAMES DEUINK | SOUTH PARK TOWERS 6000 FAIRVIEW ROAD SUITE 410 CHARLOTTE, NC 28210 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $870 | — | $870 | 4.14% |
| IVAN HINRICHS3 | 6000 FAIRVIEW ROAD SUITE 400 CHARLOTTE, NC 28210 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $4 | $19 | $23 | 0.11% |
| GIBSON INSURANCE AGENCY, INC.3 | 130 SOUTH MAIN STREET, SUITE 400 P.O. BOX 11177 SOUTH BEND, IN 46634 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $289 | $4K | 26.94% |
| GREG I HINRICHS3 | 11111 CARMEL COMMONS BLVD SUITE 125 CHARLOTTE, NC 28226 | PROVIDENT LIFE AND CASUALTY COMPANY | $160 | $159 | $319 | 9.80% |
| DANIEL WARD RICHARDSON3 | 11111 CARMEL COMMON BLVD SUITE 125 CHARLOTTE, NC 28226 | PROVIDENT LIFE AND CASUALTY COMPANY | $196 | — | $196 | 6.02% |
| JAMES WILLIAM DEUINK3 | 11111 CARMEL COMMON BLVD SUITE 125 CHARLOTTE, NC 28226 | PROVIDENT LIFE AND CASUALTY COMPANY | $160 | — | $160 | 4.91% |
| CHARLES PELUSO3 Filed as: CHARLES B PELUSO | 120 GILLS CREEK PARKWAY COLUMBIA, SC 29209 | FIRST UNUM LIFE INSURANCE COMPANY | $102 | — | $102 | 4.64% |
| GIBSON INSURANCE AGENCY, INC.3 | 130 SOUTH MAIN STREET, SUITE 400 P.O. BOX 11177 SOUTH BEND, IN 46634 | FIRST UNUM LIFE INSURANCE COMPANY | $22 | — | $22 | 1.00% |
| DAVID BEAU BOUDREAUX3 | 120-A GILLS CREEK PKWY COLUMBIA, SC 29209 | FIRST UNUM LIFE INSURANCE COMPANY | $2 | — | $2 | 0.09% |
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 | 4,325 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 114 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 4,439 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 448 | $177K |
| Vision | VISION SERVICE PLAN | 3,633 | $681K |
| Life insurance(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 4,518 | $4.2M |
| Long-term disability(6 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 4,518 | $4.2M |
| Stop-loss / reinsurancereinsurance | BERKLEY LIFE AND HEALTH INSURANCE COMPANY | 4,052 | $1.6M |
| Other(5 contracts, 4 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 4,518 | $4.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,518 | — |
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.