| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MCGRIFF INSURANCE SERVICES INC3 | P O BOX 896620 CHARLOTTE, NC 28289 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $13K | $134K | $147K | 4.30% |
| 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 | $7K | — | $7K | 10.00% |
| MCGRIFF INSURANCE SERVICES INC3 | EB COMMISSION P O BOX 896620 CHARLOTTE, NC 28289 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $9K | — | $9K | 20.00% |
| 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 | $4K | — | $4K | 10.00% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS GA | P O BOX 896620 CHARLOTTE, NC 28289 | VISION SERVICE PLAN | $1K | — | $1K | 4.21% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY LLC | 7701 AIRPORT CENTER DRIVE GREENSBORO, NC 27409 | VISION SERVICE PLAN | $569 | — | $569 | 1.67% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY LLC | 11330 LAKEFIELD DRIVE SUITE 100 JOHNS CREEK, GA 30097 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $278 | — | $278 | 3.81% |
| USI INSURANCE SERVICES LLC3 | 2502 N ROCKY POINT DR SUITE 400 TAMPA, FL 33607 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $43 | — | $43 | 0.59% |
| USI INSURANCE SERVICES LLC3 | 6100 FAIRVIEW ROAD SUITE 800 CHARLOTTE, NC 28210 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $28 | — | $28 | 0.38% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY LLC | P O BOX 70 WEST POINT, GA 31833 | METROPOLITAN LIFE INSURANCE COMPANY | $48 | — | $48 | 0.77% |
| USI INSURANCE SERVICES LLC3 | 4605 COLUMBUS STREET VIRGINIA BEACH, VA 23462 | METROPOLITAN LIFE INSURANCE COMPANY | $37 | — | $37 | 0.60% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES | P O BOX 896620 CHARLOTTE, NC 28289 | METROPOLITAN LIFE INSURANCE COMPANY | $12 | — | $12 | 0.19% |
| USI INSURANCE SERVICES LLC3 | P O BOX 66119 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $8 | — | $8 | 0.13% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 MEDICAL FEES | Named fiduciary; Contract Administrator; Direct payment from the plan; Float revenue; Non-monetary compensation; Claims processing; Participant communication; Other services Service code 12 | — | $4K |
| CIGNA | Contract Administrator; Other services; Float revenue; Claims processing; Non-monetary compensation; Named fiduciary; Participant communication; Direct payment from the plan 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 | 144 | $3.4M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 144 | $3.4M |
| Vision | VISION SERVICE PLAN | 144 | $34K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 144 | $74K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 144 | $3K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 144 | $43K |
| Other(6 contracts, 6 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 152 | $140K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 152 | — |
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.