| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 414 GALLIMORE DAIRY ROAD SUITE F GREENSBORO, NC 27409 | PRINCIPAL | $12K | $925 | $13K | 14.75% |
| THE BENEFIT COMPANY INC3 Filed as: THE BENEFIT COMPANY, INC. | PO BOX 211486 COLUMBUS, SC 29221 | PRINCIPAL | $864 | $4K | $4K | 4.98% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 3605 GLENWOOD AVENUE, SUITE 201 RELEIGH, NC 27612 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $4K | $1K | $5K | 29.38% |
| FAY JETER MARTIN3 | 19220 FOREST ROAD LYNCHBURG, VA 24502 | AFLAC | $622 | $0 | $622 | 6.61% |
| MJ INSURANCE3 Filed as: DAVID W HARLESS AND VARIOUS AGENTS | 3412 MANOR GROVE CIRCLE GLEN ALLEN, VA 23059 | AFLAC | $187 | $0 | $187 | 1.99% |
| JACQUELINE FAY MARTIN3 | 428 DEEP RUN ROAD CARTERSVILLE, VA 23027 | AFLAC | $128 | $0 | $128 | 1.36% |
| TEMPLE SCOTT JENKINS3 | 6550 GREEN BAY ROAD GREEN BAY, VA 23942 | AFLAC | $96 | $0 | $96 | 1.02% |
| JEFFREY WHITE3 | 8250 PORTERS CORSSING WAY WILMINGTON, NC 28411 | AFLAC | $51 | $0 | $51 | 0.54% |
| LEWIS K GATHRIGHT JR3 | PO BOX 165 GOOCHLAND, VA 23063 | AFLAC | $47 | $0 | $47 | 0.50% |
| WANDA LEE MADDOX3 | PO BOX 346 CROZET, VA 22932 | AFLAC | $46 | $0 | $46 | 0.49% |
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 | 180 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 184 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | OPTIMA HEALTH | 99 | $1.1M |
| Dental | AMERITAS | 292 | $107K |
| Vision | AMERITAS | 292 | $107K |
| Life insurance | PRINCIPAL | 153 | $88K |
| Short-term disability | PRINCIPAL | 153 | $88K |
| Long-term disability | PRINCIPAL | 153 | $88K |
| Prescription drug | OPTIMA HEALTH | 99 | $1.1M |
| Other(4 contracts, 4 carriers) | OPTIMA HEALTH | 153 | $1.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 292 | — |
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.