| 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 200 ATLANTA, GA 30342 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $67K | — | $67K | 14.10% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 400 GALLERIA PARKWAY SUITE 300 ATLANTA, GA 30339 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $7K | — | $7K | 1.57% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS OF GA | 5605 GLENRIDGE DRIVE SUITE 500 ATLANTA, GA 30342 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $11K | $3K | $14K | 9.47% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 400 GALLERIA PARKWAY SUITE 300 ATLANTA, GA 30339 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $53 | $53 | 0.04% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 100 MERIDIAN CENTRE BLVD SUITE 100 ROCHESTER, NY 14618 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $3K | $3K | $6K | 11.45% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS OF GA | 5606 GLENRIDGE DRIVE SUITE 300 ATLANTA, GA 30342 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $359 | — | $359 | 0.74% |
| ALLIANCE ADVISORY GRP INC3 Filed as: ALLIANCE ADVISORY GROUP INC | 350 ESSJAY ROAD WILLIAMSVILLE, NY 14221 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $55 | — | $55 | 0.11% |
| ASHFORD ADVISORS INC3 | TWO RAVINIA DRIVE SUITE 750 ATLANTA, GA 30346 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $7 | — | $7 | 0.01% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS OF GA | 5605 GLENRIDGE DRIVE SUITE 500 ATLANTA, GA 30342 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $655 | $7K | 20.48% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS OF TX | 818 TOWN AND COUNTRY BLVD SUITE 500 HOUSTON, TX 770244549 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $152 | $152 | 0.46% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 400 GALLERIA PARKWAY SUITE 300 ATLANTA, GA 30339 | UNUM LIFE INSURANCE COMPANY OF AMERICA | -$1K | -$57 | -$1K | -3.66% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 100 MERIDIAN CENTRE BLVD SUITE 100 ROCHESTER, NY 14618 | LINCOLN LIFE AND ANNUITY COMPANY OF NEW YORK | $833 | — | $833 | 8.42% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS | 5605 GLENRIDGE DRIVE SUITE 300 ATLANTA, GA 30342 | LINCOLN LIFE AND ANNUITY COMPANY OF NEW YORK | $157 | — | $157 | 1.59% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 100 MERIDIAN CENTRE BLVD SUIE 100 ROCHESTER, NY 14618 | LINCOLN LIFE AND ANNUITY COMPANY OF NEW YORK | $1K | — | $1K | 12.54% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS | 5605 GLENRIDGE DRIVE SUITE 300 ATLANTA, GA 30342 | LINCOLN LIFE AND ANNUITY COMPANY OF NEW YORK | $231 | — | $231 | 2.45% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 100 MERIDIAN CENTRE BLVD SUITE 100 ROCHESTER, NY 14618 | LINCOLN LIFE AND ANNUITY COMPANY | $961 | $232 | $1K | 12.94% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS | 5605 GLENRIDGE DRIVE SUITE 300 ATLANTA, GA 30342 | LINCOLN LIFE AND ANNUITY COMPANY | $163 | — | $163 | 1.77% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 100 MERIDIAN CENTRE BLVD SUITE 100 ROCHESTER, NY 14618 | LINCOLN LIFE AND ANNUITY COMPANY OF NEW YORK | $932 | — | $932 | 10.50% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS | 5605 GLENRIDGE DRIVE SUITE 300 ATLANTA, GA 30342 | LINCOLN LIFE AND ANNUITY COMPANY OF NEW YORK | $154 | — | $154 | 1.74% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS OF GA | 5605 GLENRIDGE DRIVE SUITE 500 ATLANTA, GA 30342 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $147 | $2K | 23.60% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS OF TX | 818 TOWN AND COUNTRY BLVD SUITE 500 HOUSTON, TX 770244549 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $23 | $23 | 0.29% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE INC | 400 GALLERIA PARKWAY SUITE 300 ATLANTA, GA 30339 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $1 | $1 | 0.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 CLAIMS ADMIN | Float revenue; Claims processing; Participant communication; Other services; Named fiduciary; Non-monetary compensation; Direct payment from the plan; Contract Administrator Service code 12 | — | $1K |
| CIGNA | Participant communication; Named fiduciary; Non-monetary compensation; Float revenue; Other services; Claims processing; Contract Administrator; Direct payment from the plan Service code 12 | — | $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 | 140 | 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) | 140 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 502 | $473K |
| Dental(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 502 | $522K |
| Vision(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 502 | $522K |
| Life insurance(4 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 281 | $196K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 281 | $145K |
| Long-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 281 | $154K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 502 | $473K |
| Other(6 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 281 | $213K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 502 | — |
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.