| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 736 MARKET STREET SUITE 1000 CHATTANOOGA, TN 374024805 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $132K | — | $132K | 9.49% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 736 MARKET STREET SUITE 1000 CHATTANOOGA, TN 374024805 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $70K | — | $70K | 10.00% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | PO BOX 896620 CHARLOTTE, NC 28289 | VISION SERVICE PLAN | $17K | — | $17K | 5.36% |
| BENEFITFOCUS.COM, INC.3 Filed as: BENEFITFOCUS COM, INC. | 100 BENEFITFOCUS WAY CHARLESTON, SC 29492 | LIFE INSURANCE COMPANY OF NORTH AMERICA | -$610 | $8K | $8K | 3.00% |
| BENEFITFOCUS.COM, INC.3 Filed as: BENEFITFOCUS COM INC | 100 BENEFITFOCUS WAY CHARLESTON, SC 29492 | LIFE INSURANCE COMPANY OF NORTH AMERICA | -$3K | $9K | $6K | 3.00% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 736 MARKET STREET SUITE 1000 CHATTANOOGA, TN 374024805 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $12K | — | $12K | 7.66% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC | PO BOX 896620 CHARLOTTE, NC 282896620 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $29K | — | $29K | 20.00% |
| BENEFITFOCUS.COM, INC.3 Filed as: BENEFITFOCUS COM, INC | 100 BENEFITFOCUS WAY CHARLESTON, SC 29492 | LIFE INSURANCE COMPANY OF NORTH AMERICA | -$577 | $4K | $4K | 3.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 CLAIMS ADMINISTRATION | Direct payment from the plan; Claims processing; Non-monetary compensation; Other services; Named fiduciary; Contract Administrator; Float revenue; Participant communication Service code 12 | — | $3.3M |
| MCGRIFF INSURANCE SERVICES, LLC EIN 56-1623293 BROKER | Other commissions; Other fees Service code 55 | — | $282K |
| DELTA DENTAL OF TENNESSEE EIN 62-0812197 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $138K |
| CIGNA | Participant communication; Float revenue; Claims processing; Non-monetary compensation; Named fiduciary; Other services; Contract Administrator; 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 | 5,424 | 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) | 5,424 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 3,414 | $309K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 6,663 | $1.4M |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 5,347 | $1.3M |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,104 | $698K |
| Stop-loss / reinsurancereinsurance | BERKLEY LIFE & HEALTH INSURANCE COMPANY | 3,940 | $1.5M |
| Other(6 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 5,355 | $943K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 6,663 | — |
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."
No prospect flags tripped on this filing.