| 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 | $94K | $20K | $114K | 6.07% |
| DENNIS M PETERSON3 | PO BOX 2916 CEDAR PARK, TX 78630 | TRANSAMERICA LIFE INSURANCE COMPANY | $66K | — | $66K | 10.45% |
| ROBERT J SKEETE3 | PO BOX 896620 CHARLOTTE, NC 28289 | TRANSAMERICA LIFE INSURANCE COMPANY | $13K | — | $13K | 2.07% |
| DALLIS C. PETERSON3 Filed as: DALLIS C PETERSON | 500 BRUSHY BRANCH RD. LOCKHART, TX 78644 | TRANSAMERICA LIFE INSURANCE COMPANY | $5K | — | $5K | 0.81% |
| FRED J. SCOTT3 Filed as: FRED J SCOTT | THE SCOTT GROUP 7951 BEAUMONT GREEN PLACE INDIANAPOLIS, IN 46250 | TRANSAMERICA LIFE INSURANCE COMPANY | $4K | — | $4K | 0.61% |
| BENEFIT ALLIANCE INC3 Filed as: BENEFIT ALLIANCE INC. | 1510 COUNTY ROAD 431 PLEASANTON, TX 78064 | TRANSAMERICA LIFE INSURANCE COMPANY | $1K | — | $1K | 0.22% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF, SEIBELS & WILLIAMS OF TX | 10100 KATY FWY SUITE 400 HOUSTON, TX 77043 | TRANSAMERICA LIFE INSURANCE COMPANY | $499 | — | $499 | 0.08% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | PO BOX 896620 CHARLOTTE, NC 28289 | TRANSAMERICA LIFE INSURANCE COMPANY | $21 | — | $21 | 0.00% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS, INC. | 897 12TH STREET HAMMONTON, NJ 08037 | TRANSAMERICA LIFE INSURANCE COMPANY | $11 | — | $11 | 0.00% |
| H&H CONSULTANTS INC.3 | PO BOX 605 GOLDENROD, FL 327330605 | TRANSAMERICA LIFE INSURANCE COMPANY | -$1K | — | -$1K | -0.21% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | PO BOX 896620 CHARLOTTE, NC 282896620 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $24K | $10K | $34K | 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 | — | $15K | $15K | 3.78% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 10100 KATY FWY SUITE 400 HOUSTON, TX 77043 | FEDERAL INSURANCE COMPANY | $32K | — | $32K | 15.00% |
| REUBEN WARNER ASSOCIATES, INC.3 | 1655 RICHMOND AVE STATEN ISLAND, NY 10314 | FEDERAL INSURANCE COMPANY | — | $32K | $32K | 15.00% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 3318 WEST FRIENDLY AVENUE 2ND FLOOR GREENSBORO, NC 27410 | ARAG SERVICES, LLC | $12K | — | $12K | 10.00% |
| REUBEN WARNER ASSOCIATES, INC.3 | 1655 RICHMOND AVE STATEN ISLAND, NY 10314 | FEDERAL INSURANCE COMPANY | — | $12K | $12K | 20.00% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 10100 KATY FWY SUITE 400 HOUSTON, TX 77043 | FEDERAL INSURANCE COMPANY | $9K | — | $9K | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 151 FARMINGTON AVENUE HARTFORD, CT 06156 | $1.9M |
| UNUM LIFE INSURANCE CO. OF AMERICA EIN 01-0278678 ADMIN SRVC PROVIDER | Plan Administrator Service code 14 | 1 FOUNTAIN SQUARE CHATTANOOGA, TN 37402 | $34K |
| LIFEWORKS (US) LTD. EIN 52-1883918 EAP ADMIN | Other services Service code 49 | 115 PERIMETER CENTER PLACE ATLANTA, GA 30346 | $15K |
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 | 1,079 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 26 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,105 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC | 95 | $903K |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 5,469 | $2.5M |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,134 | $486K |
| Prescription drug(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC | 95 | $903K |
| Stop-loss / reinsurancereinsurance | SYMETRA LIFE INSURANCE COMPANY | 1,105 | $393K |
| Other(4 contracts, 3 carriers) | TRANSAMERICA LIFE INSURANCE COMPANY | 1,137 | $1.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,469 | — |
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.