| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | PO BOX 896620 CHARLOTTE, NC 282896620 | METROPOLITAN LIFE INSURANCE COMPANY | $111K | — | $111K | 5.92% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 7701 AIRPORT CENTER DRIVE SUITE 1800 GREENSBORO, NC 27409 | METROPOLITAN LIFE INSURANCE COMPANY | — | $20K | $20K | 1.07% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS & WILLIAMS, INC. | 2211 7TH AVENUE SOUTH BIRMINGHAM, AL 352332310 | METROPOLITAN LIFE INSURANCE COMPANY | — | $3K | $3K | 0.18% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS & WILLIAMS, INC. | 10100 KATY FWY SUITE 400 HOUSTON, TX 770435267 | METROPOLITAN LIFE INSURANCE COMPANY | -$18K | — | -$18K | -0.96% |
| DENNIS M PETERSON3 | PO BOX 1703 BOERNE, TX 78006 | TRANSAMERICA LIFE INSURANCE COMPANY | $141K | — | $141K | 19.35% |
| ROBERT J SKEETE3 | 10100 KATY FWY SUITE 400 HOUSTON, TX 77043 | TRANSAMERICA LIFE INSURANCE COMPANY | $39K | — | $39K | 5.36% |
| DALLIS C. PETERSON3 Filed as: DALLIS C PETERSON | 500 BRUSHY BRANCH RD. LOCKHART, TN 78644 | TRANSAMERICA LIFE INSURANCE COMPANY | $15K | — | $15K | 2.05% |
| FRED J. SCOTT3 Filed as: FRED J SCOTT | THE SCOTT GROUP 7951 BEAUMONT GREEN PLACE INDIANAPOLIS, IN 46250 | TRANSAMERICA LIFE INSURANCE COMPANY | $10K | — | $10K | 1.31% |
| BENEFIT ALLIANCE INC3 Filed as: BENEFIT ALLIANCE INC. | PO BOX 1703 BOERNE, TX 78006 | TRANSAMERICA LIFE INSURANCE COMPANY | $2K | — | $2K | 0.32% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF, SEIBELS & WILLIAMS OF TX | 10100 KATY FWY SUITE 400 HOUSTON, TX 77043 | TRANSAMERICA LIFE INSURANCE COMPANY | $849 | — | $849 | 0.12% |
| H&H CONSULTANTS INC.3 | PO BOX 605 GOLDENROD, FL 327330605 | TRANSAMERICA LIFE INSURANCE COMPANY | $267 | — | $267 | 0.04% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 10100 KATY FWY SUITE 400 HOUSTON, TX 77043 | TRANSAMERICA LIFE INSURANCE COMPANY | $26 | — | $26 | 0.00% |
| OPEN T6 TEB3 | 1400 CENTERVIEW DRIVE LITTLE ROCK, AR 72211 | TRANSAMERICA LIFE INSURANCE COMPANY | $3 | — | $3 | 0.00% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF, SEIBELS & WILLIAMS | 10100 KATY FWY SUITE 400 HOUSTON, TX 77043 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $26K | $11K | $37K | 7.00% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 7701 AIRPORT CENTER DRIVE SUITE 1800 GREENSBORO, NC 27409 | SYMETRA LIFE INSURANCE COMPANY | — | $10K | $10K | 2.65% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS & WILLIAMS | 10100 KATY FWY SUITE 400 HOUSTON, TX 77043 | FEDERAL INSURANCE COMPANY | $36K | — | $36K | 15.00% |
| REUBEN WARNER ASSOCIATES, INC.3 | 1655 RICHMOND AVE STATEN ISLAND, NY 10314 | FEDERAL INSURANCE COMPANY | — | $36K | $36K | 15.00% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 10100 KATY FWY SUITE 400 HOUSTON, TX 77043 | ARAG SERVICES, LLC | $13K | — | $13K | 10.00% |
| REUBEN WARNER ASSOCIATES, INC.3 | 1655 RICHMOND AVE STATEN ISLAND, NY 10314 | FEDERAL INSURANCE COMPANY | — | $13K | $13K | 20.00% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS & WILLIAMS | 10100 KATY FWY SUITE 400 HOUSTON, TX 77043 | FEDERAL INSURANCE COMPANY | $10K | — | $10K | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 151 FARMINGTON AVENUE HARTFORD, CA 06156 | $1.4M |
| UNUM LIFE INSURANCE CO. OF AMERICA EIN 01-0278678 ADMIN SRVC PROVIDER | Plan Administrator Service code 14 | 1 FOUNTAIN SQUARE CHATTANOOGA, TN 37402 | $40K |
| LIFEWORKS (US) LTD. EIN 52-1883918 EAP ADMIN | Other services Service code 49 | 115 PERIMETER CENTER PLACE ATLANTA, GA 30346 | $5K |
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 | 1,295 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 25 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,320 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC | 109 | $730K |
| Vision | VISION SERVICE PLAN | 1,331 | $261K |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 6,473 | $2.6M |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,355 | $527K |
| Stop-loss / reinsurancereinsurance | SYMETRA LIFE INSURANCE COMPANY | 1,315 | $379K |
| Other(5 contracts, 4 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 6,473 | $3.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 6,473 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.