| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GASTON H GAGE JR3 Filed as: GASTON H. GAGE JR. | 6115 PARK SOUTH DRIVE SUITE 330 CHARLOTTE, NC 28210 | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | $39K | $0 | $39K | 2.50% |
| GREG I HINRICHS3 | SOUTH PARK TOWERS SUITE 400 CHARLOTTE, NC 28210 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $5K | $0 | $5K | 9.60% |
| DANIEL WARD RICHARDSON3 | 6000 FARVIEW ROAD SUITE 410 CHARLOTTE, NC 28210 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $794 | $0 | $794 | 1.48% |
| BB&T INSURANCE SERVICES, INC.3 Filed as: BB&T INSURANCE SERVICES INC | PO BOX 1847 WILSON, NC 27893 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $451 | $0 | $451 | 0.84% |
| JAMES WILLIAM DEUINK3 | SOUTH PARK TOWERS 6000 FAIRVIEW ROAD SUITE 400 CHARLOTTE, NC 28210 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $370 | $0 | $370 | 0.69% |
| BENEFIT COMMUNICATIONS INC3 | 2977 SIDCO DRIVE NASHVILLE, TN 37204 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $348 | $0 | $348 | 0.65% |
| CHARLES D. BLOCK3 Filed as: CHARLES D BLOCK | UNIT 208 648 VILLAGE PARK DRIVE WILMINGTON, NC 28405 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $6 | $0 | $6 | 0.01% |
| KEN WILLARD ASSOCIATES INC3 | 3071 VISTAPOINT ROAD MIDLOTHIAN, VA 23113 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $6 | $0 | $6 | 0.01% |
| SANDRA D OZMENT3 | 1608 OAK STREET GREENSBORO, NC 27403 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1 | $0 | $1 | 0.00% |
| DANIEL WARD RICHARDSON3 Filed as: DANIEL W. RICHARDSON | 6000 FAIRVIEW ROAD SUITE 400 CHARLOTTE, NC 28210 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | — | $6K | 25.97% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNUM LIFE INSURANCE COMPANY EIN 01-0278678 NA | Insurance services Service code 23 | ONE FOUNTAIN SQUARE 3 WEST CHATTANOOGA, TN 37402 | $5K |
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 | 178 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 178 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 178 | $1.6M |
| Life insurance(3 contracts, 3 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 250 | $84K |
| Short-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 203 | $30K |
| Long-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 203 | $34K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 178 | $1.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 250 | — |
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.
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.