| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF, SEIBELS & WILLIAMS OF TX | 818 TOWN AND COUNTRY BLVD, STE 500 HOUSTON, TX 77024 | BLUECROSS BLUESHIELD OF TEXAS | $226K | $8K | $234K | 3.01% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF, SEIBELS & WILLIAMS OF TX | 818 TOWN AND COUNTRY BLVD, STE 500 HOUSTON, TX 77024 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $42K | — | $42K | 10.00% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF, SEIBELS & WILLIAMS OFTX | 5605 GLENRIDGE DRIVE SUITE 500, 1 PREMIER PLAZA ATLANTA, GA 30342 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 0.57% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF, SEIBELS & WILLIAMS OF TX | 818 TOWN AND COUNTRY BLVD SUITE 500 HOUSTON, TX 77024 | VISION SERVICE PLAN | $2K | — | $2K | 2.96% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INS. CO. EIN 59-1031071 CLAIMS ADMINISTRATOR | Participant communication; Other services; Contract Administrator; Non-monetary compensation; Named fiduciary; Float revenue; Direct payment from the plan; Claims processing Service code 12 | — | $39K |
| PRUDENTIAL INSURANCE CO. OF AMER EIN 22-1211670 CLAIMS ADMINISTRATOR | Claims processing Service code 12 | — | $8K |
| CIGNA HEALTH & LIFE INSURANCE CO. | Other services; Float revenue; Contract Administrator; Named fiduciary; Non-monetary compensation; Claims processing; Participant communication; Direct payment from the plan Service code 12 | — | $0 |
| CIGNA HEALTH & LIFEINSURANCE CO. | Participant communication; Claims processing; Other services; Float revenue; Direct payment from the plan; Non-monetary compensation; Contract Administrator; Named fiduciary Service code 12 | — | $0 |
| EXPRO AMERICAS, LLC PLAN ADMINISTRATOR | Plan Administrator Service code 14 | 738 HIGHWAY 6 SOUTH SUITE 1000 HOUSTON, TX 77079 | $0 |
| MCGRIFF, SEIBELS AND WILLIAMS CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 818 TOWN AND COUNTRY BLVD HOUSTON, TX 77024 | $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 | 542 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 546 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TEXAS | 1,440 | $7.8M |
| Vision | VISION SERVICE PLAN | 469 | $76K |
| Life insurance | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 242 | $420K |
| Long-term disability | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 242 | $420K |
| Other | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 242 | $420K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,440 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.