| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CENTERSTONE INSURANCE AND FINANCIAL3 | 12404 PARK CENTRAL DRIVE SUITE 400S DALLAS, TX 75251 | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA | $0 | $20K | $20K | 2.15% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES LLC | 7701 AIRPORT CENTER DRIVE SUITE 1800 GREENSBORO, NC 27409 | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA | $5K | — | $5K | 0.52% |
| MCGRIFF INSURANCE SERVICES INC3 | EB COMMISSION P O BOX 896620 CHARLOTTE, NC 28289 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $22K | $4K | $26K | 12.93% |
| MCGRIFF INSURANCE SERVICES INC3 | EB COMMISSION P O BOX 896620 CHARLOTTE, NC 28289 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $14K | $2K | $16K | 12.97% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS INC | PO BOX 896620 CHARLOTTE, NC 28289 | AETNA LIFE INSURANCE COMPANY | $2K | — | $2K | 5.94% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES | 7701 AIRPORT CENTER DRIVE SUITE 1800 GREENSBORO, NC 27409 | UNUM INSURANCE COMPANY | $3K | $640 | $4K | 16.67% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES | EB COMISSION PO BOX 896620 CHARLOTTE, NC 28289 | UNUM INSURANCE COMPANY | $3K | $553 | $3K | 16.76% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES | 7701 AIRPORT CENTER DRIVE SUITE 1800 GREENSBORO, NC 27409 | UNUM INSURANCE COMPANY | $2K | $450 | $3K | 16.67% |
| MARY THERESA FISHER4 | 898 UNION CHURCH ROAD TOWNSEND, DE 19734 | PRE-PAID LEGAL SERVICES INC DBA LEGAL SHIELD | $2K | — | $2K | 13.16% |
| PATRICIA HUNT4 | 528 LONGHORN CRES ROCKVILLE, MD 20850 | PRE-PAID LEGAL SERVICES INC DBA LEGAL SHIELD | $269 | — | $269 | 1.81% |
| TODAYS THE DAY LLC4 Filed as: TODAYS THE DAY LLC DBA NATALIE GUTI | 7312 SEAWALL BLVD APT 209 GALVESTON, TX 77551 | PRE-PAID LEGAL SERVICES INC DBA LEGAL SHIELD | $68 | — | $68 | 0.46% |
| CORY WALKER4 | 4606 N LOCUST ST NORTH LITTLE ROCK, AR 72116 | PRE-PAID LEGAL SERVICES INC DBA LEGAL SHIELD | $26 | — | $26 | 0.17% |
| MCGRIFF INSURANCE SERVICES INC4 Filed as: MCGRIFF INSURANCE SERVICES | 214 N TYRON ST FLOOR 46 CHARLOTTE, NC 28202 | PRE-PAID LEGAL SERVICES INC DBA LEGAL SHIELD | $20 | — | $20 | 0.13% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD HEALTH PL GA EIN 58-1638390 ADMIN SERVICES | Contract Administrator; Claims processing; Insurance brokerage commissions and fees; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Insurance agents and brokers; Float revenue; Other commissions Service code 12 | — | $463K |
| INGENIORX EIN 82-3062245 NETWORK PHARM MGN | Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Contract Administrator; Investment management fees paid indirectly by plan; Other services Service code 12 | — | $0 |
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 | 330 | 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) | 330 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA | 508 | $930K |
| Dental | AETNA LIFE INSURANCE COMPANY | 161 | $37K |
| Vision | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA | 508 | $930K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 330 | $126K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 213 | $200K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 213 | $200K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA | 508 | $930K |
| Other(5 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 330 | $198K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 508 | — |
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.