| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WATSON INSURANCE AGENCY INC3 | P.O. BOX 879 GASTONIA, NC 28053 | PRINCIPAL LIFE INSURANCE COMPANY | $17K | $3K | $20K | 12.06% |
| MAIDEN BENEFITS GROUP INC3 | 511 ISLAND FORD RD MAIDEN, NC 28650 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9K | $1K | $10K | 15.64% |
| JAMES RUSSELL BEAM3 | 802 HAWTHORNE STREET CHEERYVILLE, NC 28021 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9K | $0 | $9K | 13.07% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: JONI BROWN | 403 N 1ST AVE MAIDEN, NC 28650 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $898 | $3K | 4.54% |
| KENNA S GEORGE3 | 6367 STARTOWN ROAD MAIDEN, NC 28650 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $170 | $2K | 2.94% |
| JEFFREY BRANDON MCREE3 | 17133 DOE VALLEY COURT CORNELIUS, NC 28031 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $501 | $2K | 2.91% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BRIAN T BROWN | 403 N 1ST AVE MAIDEN, NC 28650 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $209 | $0 | $209 | 0.32% |
| MODESTO DOMINGUEZ3 | 4220 HOULDSWORTH DRIVE CHARLOTTE, NC 28213 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $168 | $0 | $168 | 0.26% |
| STEVEN E CANIPE3 Filed as: STEVEN EDDY CANIPE | 1177 WATERFORD DRIVE HICKORY, NC 28602 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $45 | $0 | $45 | 0.07% |
| 3C HOLDINGS INC3 Filed as: 3C HOLDINGS | 908 SYDNEY DRIVE CHARLOTTE, NC 28270 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $13 | $12 | $25 | 0.04% |
| FOUNDERS FINANCIAL GROUP LLC3 Filed as: FOUNDERS FINANCIAL GROUP | 737 PLANTATION ROAD LANCASTER, SC 29720 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $13 | $11 | $24 | 0.04% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2056 VISTA PKWY WEST PALM BEACH, FL 33411 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | $1 | $9 | 0.01% |
| MORFAR STRATEGIES INC3 | 6990 GRIFFIN ROAD DAVIE, FL 33314 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $0 | $2 | 0.00% |
| GRACE V NEAD3 | 1015 STATE PARK ROAD GREENVILLE, SC 29609 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $0 | $2 | 0.00% |
| KYLE RUSSEY3 | 6921 E WEDGEWOOD AVE DAVIE, FL 33331 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $0 | $1 | 0.00% |
| ACHIOTE ENTERPRISES INC3 | 37 HENDRICKS ISLE FT. LAUDERDALE, FL 33301 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $0 | $1 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| TPAC UNDERWRITERS INC EIN 75-2396335 BENEFIT ADMIN | Claims processing; Plan Administrator Service code 12 | 3810 PHEASANT RIDGE DRIVE NE SUITE 300 MINNEAPOLIS, MN 55449 | $284K |
| CORPORATE BENEFITS SERVICE EIN 56-1167792 BENEFIT ADMIN | Claims processing; Plan Administrator Service code 12 | P.O. BOX 11937 CHARLOTTE, NC 28220 | $88K |
| CIGNA EIN 59-1031071 PPO NETWORK | Contract Administrator; Claims processing Service code 12 | — | $65K |
| WATSON INS AGENCY EIN 56-0445105 INSURANCE BROKER | Insurance agents and brokers Service code 22 | 745 E. SECOND AVE GASTONIA, NC 28052 | $51K |
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 | 224 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | 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 |
|---|---|---|---|
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 311 | $169K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 311 | $169K |
| Life insurance(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 311 | $234K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 311 | $169K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 311 | $169K |
| Other | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 116 | $65K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 311 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.