| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS GA | P O BOX 11407 BIRMINGHAM, AL 35246 | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA | $4K | — | $4K | 0.58% |
| MCGRIFF INSURANCE SERVICES INC3 | 541 NORTH MAIN STREET SUITE 100 MOUNT AIRY, NC 27030 | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA | — | $299 | $299 | 0.04% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS INC | 3400 OVERTON PARK DRIVE SE ATLANTA, GA 30339 | AETNA LIFE INSURANCE COMPANY | $13K | — | $13K | 6.06% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS GA | 3400 OVERTON PARK DRIVE SE SUITE 300 ATLANTA, GA 30339 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $20K | $1K | $21K | 13.75% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS INC | 3400 OVERTON PARK DRIVE SE SUITE 300 ATLANTA, GA 30339 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $13K | $822 | $14K | 13.77% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD HEALTH PL GA EIN 58-1638390 ADMIN SERVICES | Other services; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Other fees; Claims processing Service code 12 | — | $554K |
| MCGRIFF SEIBELS AND WILLIAMS GA | Insurance brokerage commissions and fees; Other commissions; Insurance agents and brokers Service code 22 | — | $138K |
| INGENIORX EIN 82-3062245 NETWORK PHARM MGN | Investment management fees paid indirectly by plan; Contract Administrator; Claims processing; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | -$64K |
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 | 270 | 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) | 270 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | AETNA LIFE INSURANCE COMPANY | 619 | $221K |
| Vision | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA | 537 | $678K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 270 | $101K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 219 | $151K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 219 | $151K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA | 537 | $678K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 270 | $101K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 619 | — |
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."
No prospect flags tripped on this filing.