| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC | 214 N TRYON ST. FL 46 CHARLOTTE, NC 28202 | SUN LIFE ASSURANCE COMPANY OF CANADA | $19K | $9K | $28K | 6.19% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 7701 AIRPORT CENTER DR SUITE 1800 GREENSBORO, NC 27409 | SUN LIFE ASSURANCE COMPANY OF CANADA | $26K | — | $26K | 5.71% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | PO BOX 890635 CHARLOTTE, NC 282890635 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $562 | $3K | 18.08% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $912 | $187 | $1K | 6.02% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | PO BOX 890635 CHARLOTTE, NC 282890635 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $389 | $3K | 17.77% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $704 | $129 | $833 | 5.92% |
| GIS BENEFITS INC3 Filed as: GIS OF MIDATLANTIC | 1414 KEY HIGHWAY - SUITE 300M BALTIMORE, MD 21230 | METLIFE LEGAL PLANS | $848 | — | $848 | 19.90% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | PO BOX 896620 CHARLOTTE, NC 28289 | METLIFE LEGAL PLANS | $602 | — | $602 | 14.12% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON-CHAPMAN BENEFIT ADMINISTRATORS | PO BOX 9201, BLDG I SUITE 100 AUSTIN, TX 787669201 | METLIFE LEGAL PLANS | — | $302 | $302 | 7.09% |
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 | 240 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 242 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM HEALTH PLANS OF VIRGINIA DBA ANTHEM BCBS | 464 | $2.6M |
| Dental | RELIANCE STANDARD LIFE INSURANCE COMPANY | 475 | $188K |
| Vision | RELIANCE STANDARD LIFE INSURANCE COMPANY | 475 | $188K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 249 | $460K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 249 | $460K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 249 | $460K |
| Other(4 contracts, 3 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 249 | $496K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 475 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.