| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| COVENANT BENEFIT GROUP, INC.3 Filed as: COVENANT BENEFIT GROUP INC | 1698 LEGRAND CIRCLE LAWRENCEVILLE, GA 30043 | KAISER FOUNDATION HEALTH PLAN OF GEORGIA | $17K | — | $17K | 3.44% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS OF GA | 5605 GLENRIDGE DRIVE NE SUITE 300 ATLANTA, GA 30342 | KAISER FOUNDATION HEALTH PLAN OF GEORGIA | $6K | — | $6K | 1.20% |
| COVENANT BENEFITS GROUP INC3 | 1698 LEGRAND CIRCLE LAWRENCEVILLE, GA 30043 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 10.16% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS INC | 2211 7TH AVENUE S BIRMINGHAM, AL 35233 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $689 | — | $689 | 3.76% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS INC | 5605 GLENRIDGE DRIVE SUITE 300 ATLANTA, GA 30342 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $198 | — | $198 | 1.08% |
| COVENANT BENEFITS GROUP INC3 | 1698 LEGRAND CIRCLE LAWRENCEVILLE, GA 30043 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 10.23% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS INC | 2211 7TH AVE S BIRMINGHAM, AL 35233 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $625 | — | $625 | 3.74% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS INC | 5605 GLENRIDGE DRIVE SUITE 300 ATLANTA, GA 30342 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $173 | — | $173 | 1.03% |
| COVENANT BENEFITS GROUP INC3 | 1698 LEGRAND CIRCLE LAWRENCEVILLE, GA 30043 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 10.20% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS INC | 2211 7TH AVE S BIRMINGHAM, AL 35233 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $482 | — | $482 | 3.75% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS INC | 5605 GLENRIDGE DRIVE SUITE 300 ATLANTA, GA 30342 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $133 | — | $133 | 1.04% |
| SYNERGY CORPORATE SERVICES, INC.3 Filed as: SYNERGY CORPORATE SERVICES INC | 267 W WIEUCA ROAD NE SUITE 204 ATLANTA, GA 30342 | SUN LIFE ASSURANCE COMPANY OF CANADA | $758 | — | $758 | 6.73% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS OF GA | 5605 GLENRIDGE DRIVE NE SUITE 500 ATLANTA, GA 30342 | SUN LIFE ASSURANCE COMPANY OF CANADA | $367 | — | $367 | 3.26% |
| COVENANT BENEFITS GROUP INC3 Filed as: COVENANT BENEFITS GROUP | 1698 LEGRAND CIRCLE LAWRENCEVILLE, GA 30043 | EYEMED VISION CARE | $603 | — | $603 | 8.66% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS INC | 5605 GLENRIDGE DRIVE SUITE 500 ATLANTA, GA 30342 | EYEMED VISION CARE | $166 | — | $166 | 2.38% |
No Schedule C service providers reported on this filing.
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 | 101 | 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) | 101 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN OF GEORGIA | 101 | $499K |
| Vision | EYEMED VISION CARE | 119 | $7K |
| Life insurance(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 100 | $24K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 99 | $17K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 100 | $18K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 100 | $24K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 119 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.