| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES LLC | 7701 AIRPORT CENTER DRIVE SUITE 1800 GREENSBORO, NC 27409 | ANTHEM HEALTH PLANS OF VIRGINIA DBA ANTHEM BCBS | $24K | — | $24K | 1.87% |
| HOME OFFICE TPA PAYS COMMISSION3 Filed as: HOME OFFICE TPA | 5900 O STREET LINCOLN, NE 685102234 | AMERITAS LIFE INSURANCE CORP. | $13K | — | $13K | 15.01% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES LLC | 47 AIRPARK COURT P.O. BOX 27149 GREENVILLE, SC 296162149 | AMERITAS LIFE INSURANCE CORP. | — | $3K | $3K | 3.04% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 604502215 | AMERITAS LIFE INSURANCE CORP. | — | $958 | $958 | 1.08% |
| MCGRIFF INSURANCE SERVICES INC3 | 414 GALLIMORE DAIRY ROAD GREENSBORO, NC 27409 | RELIANCE STANDARD | $7K | — | $7K | 9.04% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD | $4K | — | $4K | 5.52% |
| MCGRIFF INSURANCE SERVICES INC3 | 414 GALLIMORE DAIRY ROAD GREENSBORO, NC 27409 | RELIANCE STANDARD | $9K | — | $9K | 15.84% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD | $3K | — | $3K | 5.28% |
| MCGRIFF INSURANCE SERVICES INC3 | 414 GALLIMORE DAIRY ROAD GREENSBORO, NC 27409 | RELIANCE STANDARD | $3K | — | $3K | 22.91% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD | $818 | — | $818 | 6.17% |
| MCGRIFF INSURANCE SERVICES INC3 | 414 GALLIMORE DAIRY ROAD GREENSBORO, NC 27409 | RELIANCE STANDARD | $480 | — | $480 | 22.44% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD | $128 | — | $128 | 5.98% |
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 | 143 | 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) | 143 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM HEALTH PLANS OF VIRGINIA DBA ANTHEM BCBS | 162 | $1.3M |
| Dental | AMERITAS LIFE INSURANCE CORP. | 237 | $89K |
| Vision | AMERITAS LIFE INSURANCE CORP. | 237 | $89K |
| Life insurance(2 contracts) | RELIANCE STANDARD | 136 | $86K |
| Long-term disability | RELIANCE STANDARD | 94 | $56K |
| Other(2 contracts) | RELIANCE STANDARD | 136 | $75K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 237 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.