| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| 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 | $15K | $3K | $18K | 11.19% |
| MCGRIFF INSURANCE SERVICES INC3 | P O BOX 896620 CHARLOTTE, NC 28289 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 0.77% |
| 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 | $3K | $12K | 18.33% |
| MCGRIFF INSURANCE SERVICES INC3 | P O BOX 896620 CHARLOTTE, NC 28289 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $756 | — | $756 | 1.16% |
| 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 | $3K | $12K | 18.29% |
| MCGRIFF INSURANCE SERVICES INC3 | P O BOX 896620 CHARLOTTE, NC 28289 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $788 | — | $788 | 1.23% |
| 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 | $8K | $2K | $10K | 18.12% |
| MCGRIFF INSURANCE SERVICES INC3 | P O BOX 896620 CHARLOTTE, NC 28289 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $655 | — | $655 | 1.20% |
| 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 | $3K | $1K | $4K | 12.94% |
| MCGRIFF INSURANCE SERVICES INC3 | P O BOX 896620 CHARLOTTE, NC 28289 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $259 | — | $259 | 0.77% |
| 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 | $901 | $4K | 17.78% |
| MCGRIFF INSURANCE SERVICES INC3 | P O BOX 896620 CHARLOTTE, NC 28289 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $259 | — | $259 | 1.12% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD HEALTH PL GA EIN 58-1638390 CLAIMS ADMIN | Contract Administrator; Claims processing; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services Service code 12 | — | $326K |
| MCGRIFF INSURANCE SERVICES LLC BROKER | Insurance services; Insurance agents and brokers Service code 22 | 7701 AIRPORT CENTER DRIVE SUITE 1800 GREENSBORO, NC 27409 | $74K |
| INGENIORX INC EIN 82-3062245 PRESCRIP DRUG ADM | Float revenue; Contract Administrator; Claims processing; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $0 |
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 | 246 | 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) | 246 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 310 | $165K |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 246 | $33K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 464 | $87K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 166 | $65K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 126 | $55K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 464 | $87K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 464 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.