| 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 | $196K | — | $196K | 15.00% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS INC | 3130 CROW CANYON PLACE SUITE 400 SAN RAMON, CA 94583 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $17K | — | $17K | 15.00% |
| MCGRIFF INSURANCE SERVICES INC3 | 3130 CROW CANYON PLACE SUITE 400 SAN RAMON, CA 94583 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $11K | — | $11K | 15.00% |
| MCGRIFF INSURANCE SERVICES INC3 | 3130 CROW CANYON PLACE SUITE 400 SAN RAMON, CA 94583 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $10K | — | $10K | 15.00% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS INC | 3400 OVERTON PARK DRIVE SUITE 300 ATLANTA, GA 30339 | EYEMED VISION CARE | $5K | — | $5K | 9.99% |
| MCGRIFF INSURANCE SERVICES INC3 | 3130 CROW CANYON PLACE SUITE 400 SAN RAMON, CA 94583 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $6K | — | $6K | 15.00% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES | 214 N TRYON ST SUITE 46 CHARLOTTE, NC 28202 | CONTINENTAL AMERICAN INSURANCE COMPANY | $7K | — | $7K | 19.75% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 CLAIMS ADMIN | Claims processing; Contract Administrator; Float revenue; Non-monetary compensation; Named fiduciary; Participant communication; Direct payment from the plan; Other services Service code 12 | — | $320K |
| MCGRIFF INSURANCE SERVICES EIN 56-1623293 BROKER | Insurance agents and brokers; Insurance services Service code 22 | — | $60K |
| AMERITAS LIFE INSURANCE CORP EIN 47-0098400 CLAIMS ADMIN | Plan Administrator; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator Service code 12 | — | $29K |
| MCGRIFF INSURANCE SERVICES LLC EIN 56-1623293 BROKER | Other commissions Service code 55 | — | $6K |
| CIGNA | Direct payment from the plan; Claims processing; Non-monetary compensation; Other services; Named fiduciary; Contract Administrator; Float revenue; Participant communication 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 | 390 | 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) | 390 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | EYEMED VISION CARE | 873 | $48K |
| Life insurance(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 390 | $108K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 257 | $74K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1,087 | $1.3M |
| Other(4 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 854 | $259K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,087 | — |
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.