| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 117 SLAYDEN DRIVE THOMASTON, GA 30286 | CAREFIRST BLUECHOICE, INC. | — | $61K | $61K | 4.21% |
| KELLY & ASSOCIATES INSURANCE GROUP5 Filed as: KELLY & ASSOC INSURANCE GROUP, INC. | 1 KELLY WAY SPARKS, MD 21152 | CAREFIRST BLUECHOICE, INC. | — | $16K | $16K | 1.13% |
| KELLY & ASSOCIATES INSURANCE GROUP3 Filed as: KELLY & ASSOC INSURANCE GROUP, INC. | 1 KELLY WAY SPARKS GLENCOE, MD 21152 | HARTFORD LIFE AND ACCIDENT | $16K | $13K | $29K | 18.17% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 1 COLUMBUS CENTER SUITE 202 VIRGINIA BEACH, VA 23462 | SUN LIFE ASSURANCE COMPANY OF CANADA | $3K | — | $3K | 4.59% |
| KELLY & ASSOCIATES INSURANCE GROUP3 Filed as: KELLY & ASSOCIATES INS GROUP INC | 1 KELLY WAY SPARKS, MD 21152 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $2K | $2K | 2.74% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 999 SHADY GROVE SUITE 200 MEMPHIS, TN 38119 | SUN LIFE ASSURANCE COMPANY OF CANADA | $896 | — | $896 | 1.23% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 7701 AIRPORT CENTER DRIVE SUITE 1800 GREENSBORO, NC 274099047 | UNITEDHEALTHCARE INSURANCE COMPANY | $1K | — | $1K | 10.00% |
| KELLY & ASSOCIATES INSURANCE GROUP3 Filed as: KELLY & ASSOC INSURANCE GROUP, INC. | 1 KELLY WAY SPARKS, MD 211529484 | UNITEDHEALTHCARE INSURANCE COMPANY | $626 | — | $626 | 4.99% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | P.O. BOX 89662 CHARLOTTE, NC 28289 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $208 | $10 | $218 | 1.79% |
| JAY E. BLACK3 | 1400 MIDHURST COURT BEL AIR, MD 21014 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $13 | — | $13 | 0.11% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | P.O. BOX 89662 CHARLOTTE, NC 28289 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $135 | $3 | $138 | 2.69% |
| JAY E. BLACK3 | 1400 MIDHURST COURT BEL AIR, MD 21014 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $47 | — | $47 | 0.92% |
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 | 154 | 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) | 154 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CAREFIRST BLUECHOICE, INC. | 194 | $1.4M |
| Dental | SUN LIFE ASSURANCE COMPANY OF CANADA | 111 | $73K |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 94 | $13K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 181 | $157K |
| Short-term disability(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 181 | $162K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 181 | $157K |
| Prescription drug | CAREFIRST BLUECHOICE, INC. | 194 | $1.4M |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 181 | $170K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 194 | — |
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.