| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 | LOCKBOX #28852 NEW YORK, NY 10087 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $97K | $499 | $98K | 12.49% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 2211 7TH AVE SOUTH BIRMINGHAM, AL 35233 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $14K | — | $14K | 1.74% |
| WILLIS TOWERS WATSON US LLC3 | LOCKBOX #28852 PO BOX 28852 NEW YORK, NY 10087 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $9K | $3K | $12K | 4.68% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | PO BOX 896620 CHARLOTTE, NC 282896620 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $244 | $167 | $411 | 0.16% |
| WILLIS TOWERS WATSON US LLC3 | PO BOX 28852 COMMISSION LOCKBOX 28852 NEW YORK, NY 10087 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $3K | $1K | $4K | 2.42% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 3605 GLENWOOD AVE SUITE 201 RALEIGH, NC 27612 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $3K | — | $3K | 1.73% |
| WILLIS TOWERS WATSON US LLC3 | LOCKBOX #28852 PO BOX 28852 NEW YORK, NY 100870001 | KAISER FOUNDATION HEALTH PLAN INC | $4K | — | $4K | 3.66% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 750 B STREET STE 2400 SAN DIEGO, CA 921018114 | KAISER FOUNDATION HEALTH PLAN INC | $2K | — | $2K | 2.04% |
| BLOCK, CHARLES, D3 Filed as: BLOCK, CHARLES D | 648 VILLAGE PARK DRIVE UNIT 208 WILMINGTON, NC 28405 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | $1K | $9K | 12.85% |
| VAN EPPS, JAMES, H3 Filed as: VAN EPPS, JAMES H | 10930 CRABAPPLE RD STE 206 ROSWELL, GA 30075 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | $828 | $9K | 12.49% |
| WILLIS TOWERS WATSON US LLC3 | LOCKBOX #28852 PO BOX 28852 NEW YORK, NY 10087 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | $699 | $8K | 10.65% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | PO BOX 896620 CHARLOTTE, NC 28289 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $39 | $4 | $43 | 0.06% |
| BLOCK, CHARLES, D3 Filed as: BLOCK, CHARLES D | 648 VILLAGE PARK DR UNIT 208 WILMINGTON, NC 28405 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $11K | $874 | $11K | 20.68% |
| VAN EPPS, JAMES, H3 Filed as: VAN EPPS, JAMES H | 10930 CRABAPPLE RD STE 206 ROSWELL, GA 30075 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $11K | $665 | $11K | 20.30% |
| WILLIS TOWERS WATSON US LLC3 | PO BOX 28852 COMMISSION LOCKBOX 28852 NEW YORK, NY 10087 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $9K | $566 | $10K | 17.30% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | PO BOX 896620 CHARLOTTE, NC 28289 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $52 | $6 | $58 | 0.10% |
| WILLIS TOWERS WATSON US LLC3 | LOCKBOX #28852 PO BOX 28852 NEW YORK, NY 10087 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $10K | $626 | $11K | 22.56% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | PO BOX 896620 CHARLOTTE, NC 282896620 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $87 | $2K | 5.12% |
| BLOCK, CHARLES, D3 Filed as: BLOCK, CHARLES D | 648 VILLAGE PARK DRIVE UNIT 208 WILMINGTON, NC 28405 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $111 | $2K | 4.00% |
| VAN EPPS, JAMES, H3 Filed as: VAN EPPS, JAMES H | 10930 CRABAPPLE RD SUITE 206 ROSWELL, GA 30075 | FIRST UNUM LIFE INSURANCE COMPANY | $890 | — | $890 | 29.75% |
| BLOCK, CHARLES, D3 Filed as: BLOCK, CHARLES D | 648 VILLAGE PARK DR UNIT 208 WILMINGTON, NC 28405 | FIRST UNUM LIFE INSURANCE COMPANY | $890 | — | $890 | 29.75% |
| WILLIS TOWERS WATSON US LLC3 | LOCKBOX #28852 PO BOX 28852 NEW YORK, NY 10087 | FIRST UNUM LIFE INSURANCE COMPANY | $763 | — | $763 | 25.50% |
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 | 947 | 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) | 947 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 767 | $1.1M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 767 | $784K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 767 | $784K |
| Life insurance(3 contracts, 3 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 276 | $105K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 947 | $251K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 947 | $251K |
| Prescription drug(3 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 767 | $1.1M |
| Other(3 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 767 | $904K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 947 | — |
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.