| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MCGRIFF INSURANCE SERVICES INC3 | P.O. BOX 896620 CHARLOTTE, NC 28289 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $60K | — | $60K | 6.00% |
| MOT FINANCIAL SERVICES LLC3 | 3720 DAVINCI CT STE 150 PEACHTREE CORNERS, GA 30092 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $40K | — | $40K | 4.00% |
| HARRIS S GREEN3 | 3333 PEACHTREE RD NE STE 550 ATLANTA, GA 30326 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $76K | — | $76K | 11.01% |
| MOT FINANCIAL SERVICES LLC3 | 3720 DAVINCI CT STE 150 PEACHTREE CORNERS, GA 30092 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $9K | — | $9K | 1.23% |
| HARRIS S GREEN3 | 3333 PEACHTREE RD NE STE 550 ATLANTA, GA 30326 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $28K | — | $28K | 20.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 | P.O. BOX 3009 ARLINGTON HEIGHTS, IL 60006 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $9K | — | $9K | 14.43% |
| HARRIS S GREEN3 | 3333 PEACHTREE RD NE STE 550 ATLANTA, GA 30326 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 5.57% |
| MOT FINANCIAL SERVICES LLC3 | 37 DAVINCI COURT, STE 150 PEACHTREE CORNERS, GA 30092 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 15.00% |
| MOT FINANCIAL SERVICES LLC3 | 37 DAVINCI COURT, STE 150 PEACHTREE CORNERS, GA 30092 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 12.69% |
| HARRIS S GREEN3 | 3333 PEACHTREE RD NE STE 550 ATLANTA, GA 30326 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $458 | — | $458 | 15.00% |
| MOT FINANCIAL SERVICES LLC3 | 3720 DAVINCI CT STE 150 PEACHTREE CORNERS, GA 30092 | BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC | $11K | — | $11K | — |
| MCGRIFF INSURANCE SERVICES INC3 | P.O. BOX 896620 CHARLOTTE, NC 28289 | BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC | $8K | — | $8K | — |
| REGIONS INSURANCE INC Filed as: REGIONS INSURANCE INC. | P.O. BOX 896620 FORT SMITH, AR 72902 | BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC | $943 | — | $943 | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO. EIN 59-1031071 CLAIMS PROCESSING | Participant communication; Float revenue; Other services; Non-monetary compensation; Claims processing; Contract Administrator; Direct payment from the plan; Named fiduciary Service code 12 | 900 COTTAGE GROVE RD BLOOMFIELD, CT 06002 | $324K |
| BLUE CROSS BLUE SHIELD OF GA G0386 EIN 58-1638390 CLAIMS PROCESSING | Contract Administrator; Other services; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing Service code 12 | 3350 PEACHTREE ROAD, NE ATLANTA, GA 30326 | $86K |
| MCGRIFF INSURANCE SERVIVCES INC THIRD-PARTY | Other commissions; Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | 223 W NASH ST WILSON, NC 27893 | $63K |
| MOT FINANCIAL SERVICES THIRD-PARTY | Other commissions; Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | 3333 PEACHTREE ROAD NE ATLANTA, GA 30326 | $42K |
| CARELONRX, INC. EIN 82-3062245 THIRD-PARTY | Other services; Float revenue; Contract Administrator; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | 450 HEADQUATERS PLAZA MORRISTOWN, NJ 07960 | $7K |
| BLUE CROSS BLUE SHIELD OF GA G0385 | Other fees; Other services Service code 49 | — | $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 | 444 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 444 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 909 | $995K |
| Life insurance(3 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 444 | $852K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 444 | $693K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 444 | $693K |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 909 | $995K |
| Other(6 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 444 | $943K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 909 | — |
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.