| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS OF GA | 5605 GLENRIDGE DRIVE SUITE 500 ATLANTA, GA 30342 | COMMUNITY INSURANCE COMPANY | — | $15K | $15K | 2.75% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS OF GA | 5605 GLENRIDGE DRIVE NE SUITE 300 ATLANTA, GA 30342 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | — | $4K | 2.60% |
| HORAN ASSOCIATES INC.3 Filed as: HORAN ASSOCIATES INC | 4990 EAST GALBRAITH ROAD SUITE 102 CINCINNATI, OH 45236 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $2K | $2K | 1.48% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS OF GA | 5605 GLENRIDGE DRIVE NE SUITE 300 ATLANTA, GA 30342 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | — | $4K | 4.97% |
| HORAN ASSOCIATES INC.3 Filed as: HORAN ASSOCIATES INC | 4990 EAST GALBRAITH ROAD SUITE 102 CINCINNATI, OH 45236 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $1K | $1K | 1.42% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS OF GA | 5605 GLENRIDGE DRIVE SUITE 500 ATLANTA, GA 30342 | COMMUNITY INSURANCE COMPANY | -$51 | — | -$51 | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COMMUNITY INSURANCE COMPANY EIN 31-1440175 CLAIMS ADMIN | Contract Administrator; Claims processing; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services Service code 12 | — | $337K |
| LIFE INSURANCE CO OF NORTH AMERICA EIN 23-1503749 CONTRACT ADMINISTRATOR | Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing Service code 12 | — | $27K |
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 | 2,790 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 10 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 2,800 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COMMUNITY INSURANCE COMPANY | 0 | $0 |
| Dental(2 contracts) | COMMUNITY INSURANCE COMPANY | 399 | $332K |
| Vision | EYEMED | 1,057 | $93K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,790 | $152K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 361 | $73K |
| Stop-loss / reinsurancereinsurance | COMMUNITY INSURANCE COMPANY | 1,331 | $545K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,790 | $152K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,790 | — |
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."
No prospect flags tripped on this filing.