| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS & WILLIAMS INC. | 5605 GLENRIDGE DRIVE NE SUITE 500 ATLANTA, GA 303421376 | UNITEDHEALTHCARE INSURANCE COMPANY | $62K | — | $62K | 5.64% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS & WILLIAMS INC. | 5605 GLENRIDGE DRIVE NE SUITE 500 ATLANTA, GA 30342 | SUN LIFE ASSURANCE COMPANY OF CANADA | $3K | $626 | $4K | 3.23% |
| LIPSCOMB & PITTS INSURANCE LLC3 | 2670 UNION AVENUE EXT SUITE 100 MEMPHIS, TN 38112 | SUN LIFE ASSURANCE COMPANY OF CANADA | $1K | — | $1K | 1.02% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS & WILLIAMS INC. | 5605 GLENRIDGE DRIVE NE SUITE 500 ATLANTA, GA 30342 | SUN LIFE ASSURANCE COMPANY OF CANADA | $6K | $832 | $7K | 9.45% |
| LIPSCOMB & PITTS INSURANCE LLC3 | 2670 UNION AVENUE EXT SUITE 100 MEMPHIS, TN 38112 | SUN LIFE ASSURANCE COMPANY OF CANADA | $1K | — | $1K | 1.78% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS & WILLIAMS INC. | ONE PREMIER PLAZA ATLANTA, GA 30342 | EYEMED VISION CARE FOR FIDELITY SECURITY LIFE INSURANCE COMPANY | $2K | — | $2K | 10.63% |
| MJ INSURANCE3 Filed as: VARIOUS AGENTS - SEE ATTACHMENT | 1932 WYNNTON ROAD DEPT 434CK COLUMBUS, GA 31999 | AFLAC | $4K | $448 | $4K | 35.04% |
| RICHARD DE ASIS3 | 146 KEMP DRIVE MACEDON, NY 14502 | AFLAC | $967 | — | $967 | 36.34% |
| BRENDAN MCCARTHY AND CREW INC3 Filed as: BRENDAN MCCARTHY AND CREW INC. | 1411 CHILI AVENUE SUITE 100 ROCHESTER, NY 14624 | AFLAC | $141 | — | $141 | 5.30% |
| JUSTIN VIELE3 | 622 BENNINGTON DRIVE ROCHESTER, NY 14624 | AFLAC | $116 | — | $116 | 4.36% |
| PEYTON O'SHEA3 | 162 OAK BRIDGE WAY ROCHESTER, NY 14612 | AFLAC | $78 | — | $78 | 2.93% |
| RANDI E RIVA3 Filed as: RANDI RIVA | 340 W. PALMETTO PARK ROAD UNIT 504B BOCA RATON, FL 33432 | AFLAC | $3 | — | $3 | 0.11% |
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 | 197 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 202 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 303 | $1.1M |
| Dental | SUN LIFE ASSURANCE COMPANY OF CANADA | 165 | $122K |
| Vision | EYEMED VISION CARE FOR FIDELITY SECURITY LIFE INSURANCE COMPANY | 223 | $14K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 197 | $74K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 197 | $74K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 197 | $74K |
| Other(3 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 197 | $89K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 303 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.