| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS, INC | 5605 GLENRIDGE DRIVE, NE SUITE 500 ATLANTA, GA 30342 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $12K | $94K | $106K | 4.15% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | P O BOX 201503 DALLAS, TX 75320 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $2K | $2K | 0.09% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS OF GA | 5605 GLENRIDGE DRIVE SUITE 500 ATALNTA, GA 30342 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $10K | — | $10K | 19.86% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS | 5605 GLENRIDGE DRIVE SUITE 300 ATLANTA, GA 30342 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | — | $5K | 10.00% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS GA | 5605 GLENRIDGE DRIVE SUITE 300 ATLANTA, GA 30342 | VISION SERVICE PLAN | $1K | — | $1K | 4.12% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS GA | 5605 GLENRIDGE DRIVE SUITE 300 ATLANTA, GA 30342 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 10.00% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY LLC | 1330 NORTH PARK STREET CARROLLTON, GA 30117 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $519 | — | $519 | 3.56% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 2502 N ROCKY POINT DRIVE SUITE 400 TAMPA, FL 33607 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $107 | — | $107 | 0.73% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 3475 PIEDMONT ROAD SUITE 800 ATLANTA, GA 30305 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $61 | — | $61 | 0.42% |
| JAMES R MCCOMB3 Filed as: JAMES WILLIAM WARD | 4500 FT JACKSON BLVD 34D FLOOR COLUMBIA, SC 29209 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $6 | $6 | 0.04% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 1018 W 9TH AVENUE SUITE 100 KING OF PRUSSIA, PA 19406 | METROPOLITAN LIFE INSURANCE COMPANY | $88 | — | $88 | 0.79% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: J SMITH LANIER AND CO OF ALABAMA | P O BOX 70 WEST POINT, GA 31833 | METROPOLITAN LIFE INSURANCE COMPANY | $79 | — | $79 | 0.70% |
| WS JONES AND ASSOCIATION INC3 Filed as: W S JONES AND ASSOCIATION INC | 4850 SUGARLOAF PARKWAY SUITE 209-30 LAWRENCEVILLE, GA 30044 | METROPOLITAN LIFE INSURANCE COMPANY | $66 | — | $66 | 0.59% |
| JOANN W BUICE3 | 560 OAK CV NORCROSS, GA 30071 | METROPOLITAN LIFE INSURANCE COMPANY | $35 | — | $35 | 0.31% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: J SMITH LANIER AND CO | P O BOX 70 WEST POINT, GA 31833 | METROPOLITAN LIFE INSURANCE COMPANY | $28 | — | $28 | 0.25% |
| STEPHEN FALLON3 Filed as: STEPHEN F FALLON | 3060 PEACHTREE ROAD NW SUITE 1650 ATLANTA, GA 30305 | METROPOLITAN LIFE INSURANCE COMPANY | $20 | — | $20 | 0.18% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 1350 TREAT BLVD SUITE 550 WALNUT CREEK, CA 94597 | METROPOLITAN LIFE INSURANCE COMPANY | $14 | — | $14 | 0.12% |
| DOUGLAS BUICE3 | 560 OAK CV NORCROSS, GA 30071 | METROPOLITAN LIFE INSURANCE COMPANY | $5 | — | $5 | 0.04% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS | 5605 GLENRIDGE DRIVE SUITE 300 ATLANTA, GA 30342 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $944 | — | $944 | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 MEDICAL FEES | Non-monetary compensation; Claims processing; Other services; Float revenue; Named fiduciary; Participant communication; Contract Administrator; Direct payment from the plan Service code 12 | — | $7K |
| CIGNA | Contract Administrator; Direct payment from the plan; Claims processing; Other services; Participant communication; Named fiduciary; Non-monetary compensation; Float revenue 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 | 142 | 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) | 142 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 142 | $2.5M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 142 | $2.5M |
| Vision | VISION SERVICE PLAN | 141 | $34K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 142 | $45K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 142 | $27K |
| Other(7 contracts, 6 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 144 | $134K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 144 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.