| 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. SUITE 500 HOUSTON, TX 77024 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $180K | $403K | $583K | 2.31% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS, INC. | 897 12TH STREET HAMMONTON, NJ 08037 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $52K | $6K | $58K | 0.23% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF, SEIBELS & WILLIAMS OF TX | 818 TOWN AND COUNTRY BOULEVARD SUITE 500 HOUSTON, TX 77024 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $12K | — | $12K | 0.19% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS, INC. | 897 12 STREET HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $55K | $38K | $93K | 38.05% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF, SEIBELS & WILLIAMS OF TX | 818 TOWN AND COUNTRY BLVD SUITE 500 HOUSTON, TX 77024 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $26K | — | $26K | 10.61% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF, SEIBELS & WILLIAMS | 2211 7TH AVENUE SOUTH BIRMINGHAM, AL 35233 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $6K | $6K | 2.44% |
| CUSTOM BENEFITS PROGRAMS3 Filed as: CUSTOM BENEFITS PROGRAM, INC. | LOUIS J. PANTALONE P.O. BOX 1116 HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $403 | — | $403 | 0.16% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 700 W 47 STREET SUITE 1100 KANSAS CITY, MO 64112 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $167 | — | $167 | 0.07% |
| ROBERT J. SKEET3 | 672 FLINTDALE HOUSTON, TX 77024 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $92 | — | $92 | 0.04% |
| JO ANN PANTALONE3 | 897 12TH STREET HAMMONTON, NE 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $9 | — | $9 | 0.00% |
| REUBEN WARNER ASSOCIATES, INC.3 | 1655 RICHMOND AVENUE STATEN ISLAND, NY 10314 | FEDERAL INSURANCE COMPANY | $29K | — | $29K | 15.00% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF, SEIBELS AND WILLIAMS OF TX | 818 TOWN AND COUNTRY BLVD SUITE 500 HOUSTON, TX 77024 | FEDERAL INSURANCE COMPANY | $29K | — | $29K | 15.00% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS INC. | 897 12TH STREET HAMMONTON, NJ 08037 | FIRST UNUM LIFE INSURANCE COMPANY | $628 | — | $628 | 6.90% |
| JON M. PRATHER3 | 2706 APRIL COVE CT. MANVEL, TX 77678 | FIRST UNUM LIFE INSURANCE COMPANY | $362 | — | $362 | 3.97% |
| ROBERT J. SKEET3 | 672 FLINTDALE HOUSTON, TX 77024 | FIRST UNUM LIFE INSURANCE COMPANY | $157 | — | $157 | 1.72% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH & LIFE INS. CO. EIN 59-1031071 CONTRACT ADMINISTRATOR | Claims processing; Contract Administrator; Direct payment from the plan; Participant communication; Float revenue; Other services; Non-monetary compensation; Named fiduciary Service code 12 | — | $17.9M |
| UNUM LIFE INSURANCE CO. OF AMER. EIN 01-0278678 ADMIN SVC PROVIDER | Contract Administrator Service code 13 | — | $7K |
| CIGNA HEALTH & LIFE INSURANCE CO. | Contract Administrator; Participant communication; Named fiduciary; Claims processing; Non-monetary compensation; Direct payment from the plan; Float revenue; Other services Service code 12 | — | $0 |
| CIGNA HEALTH & LIFE INSURANCE COMPA | Non-monetary compensation; Claims processing; Participant communication; Contract Administrator; Named fiduciary; Direct payment from the plan; Other services; Float revenue 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 | 17,685 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1,086 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 18,771 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 6,632 | $21.2M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 6,632 | $6.3M |
| Vision(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 17,476 | $9.1M |
| Life insurance(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 22,920 | $25.5M |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 22,920 | $25.2M |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 22,920 | $25.2M |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 6,632 | $6.3M |
| Other(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 22,920 | $31.7M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 22,920 | — |
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."
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.