| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DANIEL J. RICKARD3 Filed as: DANIEL RICKARD | 10100 KATY FWY STE 400 HOUSTON, TX 770437043 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $48K | — | $48K | 2.23% |
| ALEXANDRA JUNEAU3 | 4409 CREEDMOOR RD STE 1970 RALEIGH, NC 276127612 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $15K | — | $15K | 0.71% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS & WILLIAMS INC - TX | PO BOX 896620 CHARLOTTE, NC 28289 | BLUE CROSS BLUE SHIELD OF MICHIGAN | — | $2K | $2K | 0.09% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS & WILLIAMS INC | PO BOX 896620 CHARLOTTE, NC 28289 | DELTA DENTAL OF MICHIGAN | $3K | — | $3K | 2.42% |
| ALLYSA DOUMITE3 | 7701 AIRPORT CENTER DRIVE SUITE 1800 GREENSBORO, NC 27409 | DELTA DENTAL OF MICHIGAN | $2K | — | $2K | 1.54% |
| DANIEL J. RICKARD3 Filed as: DANIEL RICKARD | 3400 OVERTON PARK DR SE STE 300 ATLANTA, GA 30339 | DELTA DENTAL OF MICHIGAN | $845 | — | $845 | 0.77% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | PO BOX 896620 CHARLOTTE, NC 282896620 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $702 | $6K | 13.47% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | PO BOX 896620 CHARLOTTE, NC 282896620 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $1K | $3K | 9.97% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 10100 KATY FWY STE 400 HOUSTON, TX 770435274 | AMERITAS LIFE INSURANCE CORP. | $2K | — | $2K | 8.41% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 47 AIRPARK CT. PO BOX 27419 GREENVILLE, SC 296162149 | AMERITAS LIFE INSURANCE CORP. | — | $796 | $796 | 3.08% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS & WILLIAMS INC | 10100 KATY FWY STE 400 HOUSTON, TX 770435274 | AMERITAS LIFE INSURANCE CORP. | $411 | — | $411 | 1.59% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 10100 KATY FWY STE 400 HOUSTON, TX 77043 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $601 | $2K | 13.53% |
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 | 158 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 4 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 166 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF MICHIGAN | 296 | $2.2M |
| Dental | DELTA DENTAL OF MICHIGAN | 319 | $110K |
| Vision | AMERITAS LIFE INSURANCE CORP. | 336 | $26K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 191 | $78K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 69 | $17K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 296 | $2.2M |
| Other(4 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 202 | $90K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 336 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.