| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS, INC | 3400 OVERTON PARK DRIVE SUITE 300 ATLANTA, GA 30339 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $13K | $103K | $115K | 4.16% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS INC | 3400 OVERTON PARK DRIVE SUITE 300 ATLANTA, GA 30339 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $3K | $3K | 0.12% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS OF GA | 3400 OVERTON PARK DRIVE SUITE 300 ATLANTA, GA 30339 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $9K | — | $9K | 18.36% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS | 3400 OVERTON PARK DRIVE SUITE 300 ATLANTA, GA 30339 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | — | $4K | 10.00% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS GA | P O BOX 10265 BIRMINGHAM, AL 35202 | VISION SERVICE PLAN | $2K | — | $2K | 4.44% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS GA | 3400 OVERTON PARK DRIVE SUITE 300 ATLANTA, GA 30339 | 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 | $482 | — | $482 | 3.91% |
| 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 | $105 | — | $105 | 0.85% |
| 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 | $49 | — | $49 | 0.40% |
| 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 | 0.05% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS | 3400 OVERTON PARK DRIVE SUITE 300 ATLANTA, GA 30339 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 10.00% |
| 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 | 0.81% |
| 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 | $65 | — | $65 | 0.67% |
| 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 | $27 | — | $27 | 0.28% |
| JOANN W BUICE3 | 560 OAK CV NORCROSS, GA 30071 | METROPOLITAN LIFE INSURANCE COMPANY | $14 | — | $14 | 0.14% |
| STEPHEN FALLON3 | 3060 PEACHTREE ROAD NW SUITE 1650 ATLANTA, GA 30305 | METROPOLITAN LIFE INSURANCE COMPANY | $7 | — | $7 | 0.07% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 MEDICAL FEES | Contract Administrator; Named fiduciary; Participant communication; Direct payment from the plan; Other services; Float revenue; Claims processing; Non-monetary compensation Service code 12 | — | $7K |
| CIGNA | Named fiduciary; Contract Administrator; Direct payment from the plan; Float revenue; Non-monetary compensation; Claims processing; Participant communication; 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 | 144 | 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) | 144 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 143 | $2.8M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 143 | $2.8M |
| Vision | VISION SERVICE PLAN | 140 | $34K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 134 | $43K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 134 | $28K |
| Other(7 contracts, 6 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 144 | $127K |
| 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."
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.