| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICE | — | LIFE INSURANCE COMPANY OF NORTH AMERICA | $9K | — | $9K | 15.00% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICE | — | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $3K | — | $3K | 10.00% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICE | — | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | — | $4K | 15.00% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICE | — | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 15.00% |
| NANCY H GULLIE4 | — | PREPAID LEGAL SERVICES INC DBA LEGAL SHIELD | $564 | — | $564 | 8.54% |
| AARON N CLINARD4 | — | PREPAID LEGAL SERVICES INC DBA LEGAL SHIELD | $304 | — | $304 | 4.60% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICE | — | LIFE INSURANCE COMPANY OF NORTH AMERICA | $461 | — | $461 | 10.00% |
| MCGRIFF INSURANCE SERVICES INC3 | — | HARTFORD LIFE AND ACCIDENT | $345 | — | $345 | 15.01% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICE | — | LIFE INSURANCE COMPANY OF NORTH AMERICA | $192 | — | $192 | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUMRX INC EIN 33-0441200 PHARMACY BENEFIT MANAGE | Float revenue; Claims processing; Other fees; Direct payment from the plan Service code 12 | — | $455K |
| UMR INC EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $104K |
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 | 286 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 286 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 235 | $28K |
| Life insurance(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 257 | $26K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 286 | $61K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 245 | $26K |
| Other(3 contracts, 3 carriers) | PREPAID LEGAL SERVICES INC DBA LEGAL SHIELD | 257 | $11K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 286 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.