| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MCGRIFF INSURANCE SERVICES INC3 | 414 GALLIMORE DAIRY ROAD SUITE F GREENSBORO, NC 27409 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $84K | $84K | 2.93% |
| KELLY & ASSOCIATES INSURANCE GROUP3 Filed as: KELLY & ASSOCIATES INS GROUP INC | 1 KELLY WAY SPARKS, MD 21152 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $55K | $55K | 1.92% |
| MCGRIFF INSURANCE SERVICES INC3 | 3975 FAIR RIDGE DR #110 NORTH BUILDING FAIRFAX, VA 22033 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | — | $4K | 1.46% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 3975 FAIR RIDGE DRIVE #110 NORTH BUILDING FAIRFAX, VA 22033 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $6K | — | $6K | 5.94% |
| KELLY & ASSOCIATES INSURANCE GROUP3 | 1 KELLY WAY SPARKS, MD 21152 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $743 | $892 | $2K | 1.68% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 3975 FAIR RIDGE DRIVE #110 NORTH BUILDING FAIRFAX, VA 22033 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | — | $3K | 5.02% |
| KELLY & ASSOCIATES INSURANCE GROUP3 | 1 KELLY WAY SPARKS, MD 21152 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $543 | $972 | $2K | 2.17% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 3975 FAIR RIDGE DRIVE #110 NORTH BUILDING FAIRFAX, VA 22033 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | — | $4K | 10.46% |
| KELLY & ASSOCIATES INSURANCE GROUP3 | 1 KELLY WAY SPARKS, MD 21152 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $624 | $581 | $1K | 2.83% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 3975 FAIR RIDGE DRIVE #110 NORTH BUILDING FAIRFAX, VA 22033 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $310 | — | $310 | 8.00% |
| KELLY & ASSOCIATES INSURANCE GROUP3 | 1 KELLY WAY SPARKS, MD 21152 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $73 | $44 | $117 | 3.02% |
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 | 521 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 521 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 338 | $2.9M |
| Dental | RELIANCE STANDARD LIFE INSURANCE COMPANY | 721 | $296K |
| Vision | RELIANCE STANDARD LIFE INSURANCE COMPANY | 721 | $296K |
| Life insurance(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 521 | $74K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 517 | $97K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 509 | $43K |
| Other | RELIANCE STANDARD LIFE INSURANCE COMPANY | 521 | $70K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 721 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.