| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES LLC | 550 S CALDWELL ST STE 1500 CHARLOTTE, NC 28202 | SUN LIFE ASSURANCE COMPANY OF CANADA | $45K | $14K | $58K | 9.86% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $30K | $30K | 5.00% |
| MARSH & MCLENNAN AGENCY LLC3 | 7701 AIRPORT CENTER DR STE 1800 GREENSBORO, NC 27409 | SUN LIFE ASSURANCE COMPANY OF CANADA | $14K | — | $14K | 2.34% |
| HOME OFFICE TPA PAYS COMMISSION3 Filed as: HOME OFFICE | 5900 O ST LINCOLN, NE 685102234 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $32K | — | $32K | 12.86% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MCGRIFF, A MARSH & MCLENNAN AGENCY | PO BOX 890635 CHARLOTTE, NC 282890635 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $365 | $3K | 17.01% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $675 | $183 | $858 | 4.72% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | PO BOX 890635 CHARLOTTE, NC 282890635 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $250 | $2K | 17.37% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $385 | $125 | $510 | 4.84% |
| GIS BENEFITS INC3 Filed as: GIS OF MIDATLANTIC | 1414 KEY HIGHWAY - SUITE 300M BALTIMORE, MD 21230 | METLIFE LEGAL PLANS | $775 | — | $775 | 10.19% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | P.O. BOX 896620 CHARLOTTE, NC 28289 | METLIFE LEGAL PLANS | $762 | — | $762 | 10.02% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON-CHAPMAN BENEFIT ADMINISTRATORS | PO BOX 9201, BLDG I SUITE 100 AUSTIN, TX 78766 | METLIFE LEGAL PLANS | — | $381 | $381 | 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 | 262 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 267 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM HEALTH PLANS OF VIRGINIA DBA ANTHEM BCBS | 475 | $4.0M |
| Dental | RELIANCE STANDARD LIFE INSURANCE COMPANY | 541 | $252K |
| Vision | RELIANCE STANDARD LIFE INSURANCE COMPANY | 541 | $252K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 269 | $592K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 269 | $592K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 269 | $592K |
| Other(4 contracts, 3 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 269 | $628K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 541 | — |
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."
No prospect flags tripped on this filing.