| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS OF GA | 3400 OVERTON PARK DRIVE SUITE 300 ATLANTA, GA 30339 | KAISER FOUNDATION HEALTH PLAN OF GEORGIA | $228K | — | $228K | 2.46% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS OF GA | 3400 OVERTON PARK DRIVE SUITE 300 ALTANTA, GA 30339 | HARTFORD LIFE AND ACCIDENT | $95K | — | $95K | 10.00% |
| MCGRIFF INSURANCE SERVICES INC3 | 414 GALLIMORE DAIRY ROAD SUITE F GRENSBORO, NC 27409 | HARTFORD LIFE AND ACCIDENT | — | $17K | $17K | 1.74% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS OF GA | 3400 OVERTON PARK DR SUITE 300 ATLANTA, GA 30339 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $68K | $16K | $84K | 12.71% |
| ASHFORD ADVISORS INC3 Filed as: ASHFORD ADVISORS | ONE RAVINIA DRIVE SUITE 1750 ATLANTA, GA 30346 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $59 | — | $59 | 0.01% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS | 3400 OVERTON PARK DRIVE SUITE 300 ATLANTA, GA 30339 | PAN-AMERICAN LIFE INSURANCE COMPANY | $52K | — | $52K | 13.57% |
| THE BOON INSURANCE AGENCY3 | 6300 BRIDGEPOINT PARKWAY AUSTIN, TX 78730 | TRANSAMERICA LIFE INSURANCE COMPANY | $12K | — | $12K | 10.81% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS OF GA | 3605 GLENWOOD AVENUE SUITE 201 RALEIGH, NC 27612 | TRANSAMERICA LIFE INSURANCE COMPANY | $7K | — | $7K | 5.89% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS INC | P O BOX 10265 BIRMINGHAM, AL 35202 | VISION SERVICE PLAN | $3K | — | $3K | 2.64% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PAM-AMERICAN LIFE EIN 72-0281240 CLAIMS PROC | Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Plan Administrator; Contract Administrator Service code 12 | — | $20K |
| PAN AMERICAN LIFE CLAIMS ADMIN | Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Plan Administrator Service code 12 | 601 POYDRAS STREET NEW ORLEANS, LA 70130 | $20K |
| BOON ADMINISTRATIVE SERVICES INC EIN 33-0044933 CLAIMS PROC | Other insurance fees and expenses; Claims processing; Contract Administrator Service code 12 | — | $20K |
| MCGRIFF SEIBELS AND WILLIAMS CONSULTING FEES | Insurance agents and brokers; Insurance services Service code 22 | 3400 OVERTON PARK DRIVE SUITE 300 ATLANTA, GA 30339 | $18K |
| PAN AMERICAN BENEFIT SOLUTIONS NETWORK ACCESS FEES | Other insurance fees and expenses Service code 73 | 1778 NO PLANO ROAD SUITE 310 RICHARDSON, TX 75081 | $18K |
| RXEDO PHARM BENE MGR | Other fees Service code 99 | P O BOX 678586 DALLAS, TX 75267 | $321 |
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 | 2,382 | 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) | 2,382 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN OF GEORGIA | 1,367 | $9.3M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,414 | $662K |
| Vision | VISION SERVICE PLAN | 1,421 | $99K |
| Life insurance(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 2,382 | $1.1M |
| Long-term disability(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 2,382 | $1.1M |
| Stop-loss / reinsurancereinsurance | PAN-AMERICAN LIFE INSURANCE COMPANY | 254 | $382K |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 2,382 | $1.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,382 | — |
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.