| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC | ATTN BONNIE EDWARDS 414 GALLIMORE DAIRY RD #F GREENSBORO, NC 27409 | HARTFORD LIFE AND ACCIDENT | $12K | $6K | $18K | 15.71% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTL MIDWEST LIMITED | 55 E JACKSON STE 14B CHICAGO, IL 60604 | HARTFORD LIFE AND ACCIDENT | $5K | — | $5K | 4.46% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 15162 COLLECTION CENTER DR CHICAGO, IL 60693 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | — | $7K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD #600 CHICAGO, IL 606044402 | AMERITAS LIFE INSURANCE CORP | $3K | — | $3K | 7.00% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES | 47 AIRPARK CT PO BOX 27149 GREENVILLE, SC 296162149 | AMERITAS LIFE INSURANCE CORP | — | $2K | $2K | 3.26% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES | 3318 W FRIENDLY AVE STE 400 GREENSBORO, NC 274104885 | AMERITAS LIFE INSURANCE CORP | $690 | — | $690 | 1.42% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 15162 COLLECTION CENTER DR CHICAGO, IL 60693 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 15.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 15162 COLLECTION CENTER DR CHICAGO, IL 60693 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 15162 COLLECTION CENTER DR CHICAGO, IL 60693 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 15162 COLLECTION CENTER CHICAGO, IL 606930001 | VISION SERVICE PLAN | $701 | — | $701 | 7.78% |
| RUTHERFORD FINANCIAL SERVICES INC.3 Filed as: MCGRIFFF INS SVCS INC | 3605 GLENWOOD AVE SUITE 190 RALEIGH, NC 276124959 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $372 | — | $372 | 5.01% |
| THE BENEFIT COMPANY INC3 | PO BOX 211486 COLUMBIA, SC 29221 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $371 | — | $371 | 5.00% |
| THE BENEFIT COMPANY INC3 | PO BOX 211486 COLUMBIA, SC 29221 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $375 | — | $375 | 5.40% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INS SVCS INC | 3605 GLENWOOD AVE SUITE 190 RALEIGH, NC 276124959 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $356 | — | $356 | 5.12% |
| THE BENEFIT COMPANY INC3 | PO BOX 211486 COLUMBIA, SC 29221 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $281 | — | $281 | 4.91% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INS SVCS INC | 3605 GLENWOOD AVE SUITE 190 RALIEGH, NC 276124959 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $279 | — | $279 | 4.88% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 55 E JACKSON BLVD CHICAGO, IL 60604 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $65 | — | $65 | 1.14% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC | PO BOX 2158 RIVERSIDE, CA 92516 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | — | $3 | $3 | 0.05% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INS SVCS INC | 3605 GLENWOOD AVE SUITE 190 RALEIGH, NC 276124959 | AMERICAN HERITGE LIFE INSURANCE COMPANY | $253 | — | $253 | 5.27% |
| THE BENEFIT COMPANY INC3 | PO BOX 211486 COLUMBIA, SC 29221 | AMERICAN HERITGE LIFE INSURANCE COMPANY | $253 | — | $253 | 5.27% |
| THE BENEFIT COMPANY INC3 Filed as: THE BENEFIT COMPANY INC. | PO BOX 211486 COLUMBIA, SC 29221 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $297 | — | $297 | 6.36% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INS SVCS INC | 3605 GLENWOOD AVE SUITE 190 RALEIGH, NC 276124959 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $236 | — | $236 | 5.05% |
| THE BENEFIT COMPANY INC3 | PO BOX 211486 COLUMBIA, SC 29229 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $3 | — | $3 | 0.06% |
| THE BENEFIT COMPANY INC3 | PO BOX 211486 COLUMBIA, SC 29221 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $244 | — | $244 | 5.96% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INS SVCS INC | 3605 GLENWOOD AVE SUITE 190 RALEIGH, NC 276124959 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $235 | — | $235 | 5.74% |
| THE BENEFIT COMPANY INC3 | PO BOX 211486 COLUMBIA, SC 29221 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $185 | — | $185 | 5.57% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INS SVCS INC | 3605 GLENWOOD AVE SUITE 190 RALEIGH, NC 276124959 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $184 | — | $184 | 5.54% |
| THE BENEFIT COMPANY INC3 | PO BOX 211486 COLUMBIA, SC 29221 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $212 | — | $212 | 7.02% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INS SVCS INC | 3605 GLENWOOD AVE SUITE 190 RALEIGH, NC 276124959 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $138 | — | $138 | 4.57% |
| THE BENEFIT COMPANY INC3 | PO BOX 211486 COLUMBIA, SC 29229 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $14 | — | $14 | 0.46% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $34K |
| HUB INTERNATIONAL MIDWEST LTD EIN 35-0672425 BROKER | Other commissions Service code 55 | ATTN ACCOUNTING 55 E JACKSON BLVD STE 14B CHICAGO, IL 60604 | $9K |
| UNITED OF OMAHA LIFE INS COMPANY EIN 47-0322111 CONTRACT ADMINISTRATOR | Claims processing; Contract Administrator Service code 12 | — | $7K |
| RXBENEFITS, INC. EIN 63-1157085 NONE | Claims processing Service code 12 | — | $1K |
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 | 219 | 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) | 224 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 367 | $119K |
| Vision | VISION SERVICE PLAN | 145 | $9K |
| Life insurance(3 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 220 | $164K |
| Long-term disability(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 220 | $141K |
| Stop-loss / reinsurancereinsurance | TOKIO MARINE | 194 | $63K |
| Other(10 contracts, 4 carriers) | HARTFORD LIFE AND ACCIDENT | 220 | $183K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 367 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.