| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES INC. | 1150 JULIAN DR. STE 100 WATKINSVILLE, GA 30677 | CIGNA HEALTH AND LIFE INSURANCE | $41K | — | $41K | 9.13% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES INC. | 1150 JULIAN DR STE 100 WATKINSVILLE, GA 30677 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $12K | $671 | $13K | 17.28% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES INC. | 3605 GLENWOOD AVENUE SUITE 201 RALEIGH, NC 27612 | AXIS INSURANCE COMPANY | $3K | — | $3K | 10.42% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES INC. | PO BOX 896620 CHARLOTTE, NC 28289 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | — | $2K | 21.22% |
| PATTERSON DANIEL HAMMOND3 | 2703 EAST LAKE ROAD MCDONOUGH, GA 30252 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $48 | — | $48 | 0.58% |
| THE A.I. GROUP INC3 Filed as: THE A.I GROUP INC. | 12725 MORRIS RD BLDG 100 SUITE 200 ALPHARETTA, GA 30004 | BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC. | $96 | $85 | $181 | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO. EIN 59-1031071 INSURANCE CARRIER | Other services; Named fiduciary; Direct payment from the plan; Contract Administrator; Participant communication; Float revenue; Non-monetary compensation; Claims processing Service code 12 | — | $11K |
| CIGNA HEALTH & LIFE INSURANCE CO. | Participant communication; Non-monetary compensation; Other services; Claims processing; Direct payment from the plan; Contract Administrator; Named fiduciary; Float revenue 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 | 150 | 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) | 150 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE | 150 | $474K |
| Dental(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE | 150 | $474K |
| Vision | BLUE CROSS AND BLUE SHIELD OF GEORGIA, INC. | 1 | $0 |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 114 | $74K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 114 | $74K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 114 | $74K |
| Prescription drug(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 114 | $99K |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 114 | $82K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 150 | — |
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.