| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS INC | 3400 OVERTON PARK DRIVE SE SUITE 300 ATLANTA, GA 30339 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $98K | — | $98K | 21.69% |
| AXA ASSISTANCE, USA5 Filed as: AXA ASSISTANCE USA | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 60603 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $106 | $106 | 0.02% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS INC | 3400 OVERTON PARK DRIVE SUITE 300 ATLANTA, GA 30339 | HARTFORD LIFE AND ACCIDENT | $43K | — | $43K | 13.87% |
| MCGRIFF INSURANCE SERVICES INC3 | ATTN DAVID YOPP 4309 EMPEROR BLVD, SUITE 300 DURHAM, NC 27703 | HARTFORD LIFE AND ACCIDENT | — | $4K | $4K | 1.23% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS INC | 3400 OVERTON PARK DRIVE SUITE 300 ATLANTA, GA 30339 | METROPOLITAN LIFE INSURANCE COMPANY | — | $34 | $34 | 0.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUMRX INC EIN 33-0441200 PHARM BENE MGMT | Claims processing; Other fees; Float revenue; Direct payment from the plan Service code 12 | — | $732K |
| UMR INC EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $88K |
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 | 300 | 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) | 300 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 539 | $229K |
| Vision | EYEMED VISION CARE | 350 | $19K |
| Life insurance(2 contracts, 2 carriers) | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 300 | $760K |
| Long-term disability | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 300 | $454K |
| Stop-loss / reinsurancereinsurance | UNITED HEALTHCARE INSURANCE COMPANY | 214 | $398K |
| Other | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 300 | $454K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 539 | — |
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.