| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH USA LLC | PO BOX 28031 NEW YORK, NY 10087 | UNITEDHEALTHCARE INSURANCE COMPANY | $3K | $32K | $34K | 1.65% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES INC. | 10100 KATY FWY STE 400 HOUSTON, TX 77043 | UNITEDHEALTHCARE INSURANCE COMPANY | $2K | $30K | $32K | 1.53% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH USA | 5555 GLENRIDGE CONNECTOR SUITE 600 ATLANTA, GA 30342 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $5K | — | $5K | 5.57% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 405 E. ST. PETER STREET NEW IBERIA, LA 70560 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | — | $4K | 4.43% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH USA | 5555 GLENRIDGE CONNECTOR STE 600 ATLANTA, GA 30342 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 5.58% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICE, INC. | 405 E. ST. PETER STREET NEW IBERIA, LA 70560 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 4.42% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH USA | 5555 GLENRIDGE CONNECTOR SUITE 600 ATLANTA, GA 30342 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 5.56% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICE, INC. | 405 E. ST. PETER STREET NEW IBERIA, LA 70560 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 4.44% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH USA | 5555 GLENRIDGE CONNECTOR SUITE 600 ATLANTA, GA 30342 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $833 | — | $833 | 5.71% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICE, INC. | 405 E. ST. PETER STREET NEW IBERIA, LA 70560 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $626 | — | $626 | 4.29% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH USA | 5555 GLENRIDGE CONNECTOR STE 600 ATLANTA, GA 30342 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $694 | — | $694 | 8.32% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICE, INC. | 405 E. ST. PETER STREET NEW IBERIA, LA 70560 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $557 | — | $557 | 6.67% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICE, INC. | 405 E. ST. PETER STREET NEW IBERIA, LA 70560 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $527 | — | $527 | 8.63% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH USA | 5555 GLENRIDGE CONNECTOR SUITE 600 ATLANTA, GA 30342 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $520 | — | $520 | 8.51% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICE, INC. | 405 E. ST. PETER STREET NEW IBERIA, LA 70560 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $382 | — | $382 | 9.03% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH USA | 5555 GLENRIDGE CONNECTOR SUITE 600 ATLANTA, GA 30342 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $348 | — | $348 | 8.22% |
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 | 115 | 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) | 115 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 266 | $2.1M |
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 266 | $2.1M |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 266 | $2.1M |
| Life insurance(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 115 | $58K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 115 | $84K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 115 | $34K |
| Other(4 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 115 | $62K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 266 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.