| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES INC. | 130 THEORY, SUITE 200 IRVINE, CA 92617 | MEDICA INSURANCE COMPANY | $65K | $2K | $67K | 2.35% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 2211 7TH AVENUE SOUTH BIRMINGHAM, AL 35233 | MEDICA INSURANCE COMPANY | $13K | — | $13K | 0.47% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | PO BOX 896620 CHARLOTTE, NC 28289 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $43K | $4K | $48K | 13.93% |
| MARC A GROVE3 Filed as: MARC A. GROVE | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $289 | $1K | 2.71% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC. | 15400 28TH AVENUE NORTH PLYMOUTH, MN 55447 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $849 | $0 | $849 | 1.74% |
| ELIZABETH MARIE LANGEVIN3 Filed as: ELIZABETH LANGEVIN AND OTHER AGENTS | 698 WEST LARPENTER AVENUE SAINT PAUL, MN 55113 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $648 | $19 | $667 | 1.36% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES INC. | 7701 AIRPORT CENTER DRIVE GREENSBORO, NC 27409 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $392 | $0 | $392 | 0.80% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KLH INSURANCE INC. | 6505 DEMPSEY AVENUE SW WAVERLY, MN 55390 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $190 | $56 | $246 | 0.50% |
| MEGHAN MOFFATT LUCAS3 | 2650 ACORN RUN VICTORIA, MN 55386 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $154 | $9 | $163 | 0.33% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5 | $0 | $5 | 0.01% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | PO BOX 896620 CHARLOTTE, NC 28289 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $779 | $4K | 15.68% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC. | 701 B STREET, SUITE 600 SAN DIEGO, CA 92101 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 6.53% |
| FRED HAUENSTEIN3 | 13370 HUNTINGTON CIRCLE APPLE VALLEY, MN 55124 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $339 | $0 | $339 | 1.31% |
| HAYS COMPANIES, INC.3 | 80 SOUTH 8TH STREET, SUITE 700 MINNEAPOLIS, MN 55402 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $42 | $0 | $42 | 0.16% |
| HAROLD L WINTERHALTER3 Filed as: HAROLD WINTERHALTER | 3870 TROY LANE NORTH PLYMOUTH, MN 55446 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | -$1 | $0 | -$1 | -0.00% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 3400 OVERTON PARK DRIVE SE ATLANTA, GA 30339 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $1K | $0 | $1K | 7.35% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF, SEIBLES AND WILLIAMS, INC. | 3400 OVERTON PARK DRIVE, SUITE 300 ATLANTA, GA 30339 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $727 | $0 | $727 | 5.01% |
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 | 424 | 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) | 424 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MEDICA INSURANCE COMPANY | 462 | $2.8M |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 206 | $15K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 424 | $341K |
| Short-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 424 | $367K |
| Long-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 424 | $367K |
| Prescription drug | MEDICA INSURANCE COMPANY | 462 | $2.8M |
| Other(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 424 | $395K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 462 | — |
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.