| 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 | $82K | — | $82K | 17.89% |
| MCGRIFF INSURANCE SERVICES INC5 Filed as: MCGRIFF SEIBELS AND WILLIAMS INC | 2211 7TH AVE SOUTH BIRMINGHAM, AL 35233 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 0.75% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $55 | $55 | 0.01% |
| AXA ASSISTANCE, USA5 Filed as: AXA ASSISTANCE USA | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 60603 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $9 | $9 | 0.00% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS INC | 3400 OVERTON PARK DRIVE SUITE 300 ATLANTA, GA 30339 | HARTFORD LIFE AND ACCIDENT | $45K | — | $45K | 13.88% |
| MCGRIFF INSURANCE SERVICES INC3 | 628 GREEN VALLEY ROAD SUITE 304 GREENSBORO, NC 27408 | HARTFORD LIFE AND ACCIDENT | — | $5K | $5K | 1.61% |
| 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 | — | $921K |
| UMR, INC EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $78K |
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 | 283 | 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) | 283 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 527 | $228K |
| Vision | EYEMED VISION CARE | 364 | $25K |
| Life insurance(2 contracts, 2 carriers) | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 301 | $783K |
| Long-term disability | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 301 | $460K |
| Other | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 301 | $460K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 527 | — |
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.