| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS INC | 5605 GLENRIDGE DRIVE SUITE 300 ATLANTA, GA 30342 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $3K | $7K | 8.59% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLAIMS INC | 5605 GLENRIDGE DRIVE SUITE 300 ATLANTA, GA 30342 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $1K | $6K | 18.05% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS INC | 5605 GLENRIDGE DRIVE SUITE 300 ATLANTA, GA 30342 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $756 | $4K | 18.17% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS INC | 5605 GLENRIDGE DRIVE SUITE 300 ATLANTA, GA 30342 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $126 | $126 | 0.84% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS INC | 5605 GLENRIDGE DRIVE NE SUITE 500 ATLANTA, GA 303421376 | UNITEDHEALTHCARE INSURANCE COMPANY | $833 | — | $833 | 10.00% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS INC | 5605 GLENRIDGE DRIVE SUITE 300 ATLANTA, GA 30342 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $253 | $1K | 18.10% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MCGRIFF SEIBELS AND WILLIAMS BROKER | Insurance services; Insurance agents and brokers Service code 22 | 5605 GLENRIDGE DRIVE SUITE 300 ATLANTA, GA 30342 | $57K |
| MCGRIFFL SEIBELS AND WILLIAMS 22 23 | Insurance agents and brokers; Insurance services Service code 22 | 5605 GLENRIDGE DRIVE SUITE 300 ATLANTA, GA 30342 | $7K |
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 | 137 | 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. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 137 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | AETNA HEALTH INC | 241 | $1.3M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 354 | $85K |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 79 | $8K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 137 | $8K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 88 | $15K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 128 | $34K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 137 | $32K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 354 | — |
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.