| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MCGRIFF INSURANCE SERVICES INC3 | P O BOX 896620 CHARLOTTE, NC 28289 | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA | $51K | $2K | $53K | 10.58% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS OF GA | 3400 OVERTON PARK DRIVE SUITE 300 ATLANTA, GA 30342 | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA | $36K | — | $36K | 7.30% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WWILLIAMS INC | 10100 KATY FWY SUITE 400 HOUSTON, TX 77043 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $14K | — | $14K | 10.00% |
| MCGRIFF INSURANCE SERVICES INC3 | 2211 7TH AVE S BIRMINGHAM, AL 35233 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $3K | $3K | 1.97% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS INC | 10100 KATY FWY SUITE 400 HOUSTON, TX 77043 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $9K | — | $9K | 15.00% |
| MCGRIFF INSURANCE SERVICES INC3 | 2211 7TH AVE S BIRMINGHAM, AL 35233 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 3.35% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS INC | 10100 KATY FWY SUITE 400 HOUSTON, TX 77043 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $9K | — | $9K | 15.00% |
| MCGRIFF INSURANCE SERVICES INC3 | 2211 7TH AVE S BIRMINGHAM, AL 35233 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 3.64% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS INC | 10100 KATY FWY SUITE 400 HOUSTON, TX 77043 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | — | $7K | 15.00% |
| MCGRIFF INSURANCE SERVICES INC3 | 2211 7TH AVE S BIRMINGHAM, AL 35233 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 3.53% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS INC | 10100 KATY FWY SUITE 400 HOUSONT, TX 77043 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| MCGRIFF INSURANCE SERVICES INC3 | 2211 7TH AVE S BIRMINGHAM, AL 35233 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $855 | $855 | 3.46% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS INC | 10100 KATY FWY SUITE 400 HOUSTON, TX 77043 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 15.00% |
| MCGRIFF INSURANCE SERVICES INC3 | 2211 7TH AVE S BIRMINGHAM, AL 35233 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $758 | $758 | 3.83% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD HEALTH PL GA EIN 58-1638390 CLAIMS ADMIN | Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services; Claims processing; Contract Administrator; Float revenue Service code 12 | — | $450K |
| INGENIORX INC EIN 82-3062245 PRESCRIP DRUG ADM | Float revenue; Other services; Claims processing; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $67K |
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 | 245 | 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) | 245 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 267 | $138K |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 194 | $25K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 403 | $79K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 156 | $63K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 119 | $47K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA | 414 | $498K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 403 | $79K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 414 | — |
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.