| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS OF GA | 5605 GLENRIDGE DRIVE NE SUITE 300 ATLANTA, GA 30342 | KAISER FOUNDATION HEALTH PLAN OF GEORGIA | $212K | — | $212K | 3.67% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS OF GA | 5605 GLENRIDGE DRIVE SUITE 300 ATLANTA, GA 30342 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $36K | — | $36K | 8.00% |
| B B AND T INSURANCE SERVICES INC3 | 414 GALLIMORE DAIRY ROAD SUITE F GREENSBORO, NC 27409 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | — | $13K | $13K | 2.81% |
| ASHFORD ADVISORS INC3 | ONE RAVINIA DRIVE SUITE 1750 ATLANTA, GA 30346 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $585 | — | $585 | 0.13% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS OF GA | 5605 GLENRIDGE DRIVE SUITE 300 ATLANTA, GA 30342 | TRANSAMERICA LIFE INSURANCE COMPANY | $67K | — | $67K | 15.70% |
| MITCH BESVINICK3 | INNOBENEFITS LLC 1280 BRIGHTON WAY NEW TOWN SQUARE, PA 19073 | TRANSAMERICA LIFE INSURANCE COMPANY | $17K | — | $17K | 3.90% |
| THE BOON INSURANCE AGENCY3 | 6300 BRIDGEPOINT PARKWAY BUILDING 3 SUITE 500 AUSTIN, TX 78730 | TRANSAMERICA LIFE INSURANCE COMPANY | $9K | — | $9K | 9.94% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS INC | 2211 7TH AVENUE SOUTH BIRMINGHAM, AL 35233 | TRANSAMERICA LIFE INSURANCE COMPANY | $7K | — | $7K | 7.06% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS OF GA | 5605 GLENRIDGE DRIVE SUITE 300 ATLANTA, GA 30342 | VISION SERVICE PLAN | $2K | — | $2K | 3.00% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS OF GA | 5605 GLENRIDGE DRIVE SUITE 500 ATLANTA, GA 30342 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $418 | $34 | $452 | 21.62% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BOON ADMINISTRATIVE SERVICES INC EIN 33-0449333 CLAIMS PROC | Direct payment from the plan; Contract Administrator; Claims processing; Insurance services; Float revenue Service code 12 | — | $107K |
| KEY BENEFIT ADMINISTRATORS INC EIN 35-1450364 CLAIMS PROC | Recordkeeping and information management (computing, tabulating, data processing, etc.); Plan Administrator; Claims processing; Contract Administrator Service code 12 | — | $40K |
| MULTIPLAN EIN 35-2048379 CLAIMS PROC | Plan Administrator; Claims processing; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $18K |
| RGI LLC EIN 32-0176370 CLAIMS PROC | Plan Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Claims processing Service code 12 | — | $13K |
| AMERICAN HEALTH DATA INSTITUTE EIN 35-2048379 CLAIMS PROCE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Claims processing; Plan Administrator Service code 12 | — | $6K |
| MITCH BESVINICK CLAIMS PROC | Plan Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Contract Administrator Service code 12 | 1280 BRIGHTON WAY NEW TOWN SQUARE, PA 19073 | $5K |
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 | 971 | 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) | 971 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN OF GEORGIA | 971 | $5.8M |
| Dental(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,162 | $470K |
| Vision | VISION SERVICE PLAN | 1,059 | $67K |
| Life insurance(3 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 2,291 | $1.2M |
| Long-term disability(3 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 2,291 | $1.2M |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 2,291 | $644K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,291 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.