| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS | 3400 OVERTON PARK DRIVE SUITE 300 ATLANTA, GA 30339 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $82K | — | $82K | 15.00% |
| MCGRIFF INSURANCE SERVICES INC3 | P O BOX 896620 CHARLOTTE, NC 28289 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $5K | — | $5K | 12.33% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS INC | 3400 OVERTON PARK DRIVE SUITE 300 ATLANTA, GA 30339 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | — | $1K | 2.67% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS INC | 3400 OVERTON PARK DRIVE SUITE 300 ATLANTA, GA 30339 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 3.21% |
| TYLER HERRINGTON TORBETT3 | 3604 ROBINSON WALK DRIVE MARIETTA, GA 30068 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $748 | — | $748 | 2.21% |
| CAROL PURDY FIELDS3 | 204 POTOMAC COURT WOODSTOCK, GA 30188 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $441 | — | $441 | 1.30% |
| NORMAC SOLUTIONS INC3 | 3730 EVEREST DRIVE MONTGOMERY, AL 36106 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $349 | — | $349 | 1.03% |
| KLD INSURANCE BENEFITS INC3 | 9085 BETHEL ROAD GAINESVILLE, GA 30506 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $348 | — | $348 | 1.03% |
| MITCHELL HECTOR MORALES3 | 4679 SCORE COURT SNELLVILLE, GA 30339 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $134 | — | $134 | 0.40% |
| ASSUREDPARTNERS3 Filed as: JENNIFER ROSE SMITH | 4920 W SAN RAFAEL ST TAMPA, FL 33629 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $28 | — | $28 | 0.08% |
| LAURA B WETT3 | 8194 HYDE AVENUE SOUTH COTTAGE GROVE, MN 55016 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.01% |
| MCGRIFF INSURANCE SERVICES INC3 | P O BOX 896620 CHARLOTTE, NC 28289 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | — | $3K | 12.15% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS INC | 3400 OVERTON PARK DRIVE SUITE 300 ATLANTA, GA 30339 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $754 | — | $754 | 2.85% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS INC | 3400 OVERTON PARK DRIVE SUITE 300 ATLANTA, GA 30339 | EYEMED VISION CARE | $2K | — | $2K | 8.89% |
| MCGRIFF INSURANCE SERVICES INC3 | P O BOX 896620 CHARLOTTE, NC 28289 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | — | $3K | 12.06% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS INC | 3400 OVERTON PARK DRIVE SUITE 300 ATLANTA, GA 30339 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $609 | — | $609 | 2.94% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS INC | P O BOX 896620 CHARLOTTE, NC 28289 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 12.39% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS INC | 3400 OVERTON PARK DRIVE SUITE 300 ATLANTA, GA 30339 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $373 | — | $373 | 2.61% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 59-1031071 CLAIMS ADMIN | Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Plan Administrator; Claims processing Service code 12 | — | $85K |
| MCGRIFF SEIBELS AND WILLIAMS | Insurance agents and brokers; Insurance services Service code 22 | — | $33K |
| AMERITAS LIFE INSURANCE CORP EIN 47-0098400 CLAIMS ADMIN | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Claims processing; Plan Administrator Service code 12 | — | $13K |
| MCGRIFF SEIBELS AND WILLIAMS OF GA EIN 58-1830491 BROKER | Other commissions Service code 55 | — | $2K |
| 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 | 229 | 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) | 229 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 513 | $548K |
| Vision | EYEMED VISION CARE | 800 | $26K |
| Life insurance(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 352 | $35K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 247 | $26K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 513 | $548K |
| Other(4 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 704 | $107K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 800 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.