| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 47 AIRPARK COURT GREENVILLE, SC 29607 | BLUE CHOICE HEALTH PLAN OF SOUTH CAROLINA | $61 | — | $61 | 0.01% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES INC. | P.O. BOX 896620 CHARLOTTE, NC 28289 | DELTA DENTAL OF MISSOURI | $4K | $396 | $5K | 9.52% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES INC. | P.O. BOX 27149 GREENVILLE, SC 29616 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | — | $5K | 14.37% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES INC. | 300 SUMMERS STREET SUITE 650 CHARLESTON, WV 25301 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 5.87% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES INC. | P.O. BOX 27149 GREENVILLE, SC 29616 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 10.00% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES INC. | 300 SUMMERS ST. SUITE 650 CHARLESTON, WV 25301 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 5.77% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES INC. | 3150 S. MAIN ST. HARRISONBURG, VA 22801 | SUN LIFE ASSURANCE COMPANY OF CANADA | $4K | $529 | $5K | 17.20% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES INC. | P.O. BOX 27149 GREENVILLE, SC 29616 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 13.75% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES INC. | 300 SUMMERS ST. SUITE 650 CHARLESTON, WV 25301 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 6.16% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES INC. | P.O. BOX 27149 GREENVILLE, SC 29616 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 10.00% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES INC. | 300 SUMMERS ST. SUITE 650 CHARLESTON, WV 25301 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $145 | $145 | 1.43% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES INC. | P.O. BOX 27149 GREENVILLE, SC 29616 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $613 | — | $613 | 10.01% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES INC. | 300 SUMMERS STREET SUITE 650 CHARLESTON, WV 25301 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $389 | $389 | 6.35% |
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 | 105 | 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) | 105 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CHOICE HEALTH PLAN OF SOUTH CAROLINA | 106 | $877K |
| Dental | DELTA DENTAL OF MISSOURI | 178 | $51K |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 94 | $10K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 128 | $40K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 128 | $30K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 128 | $20K |
| Other(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 128 | $67K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 178 | — |
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.