| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 2300 W NASH STREET WILSON, NC 27893 | BLUE CROSS AND BLUE SHIELD OF TEXAS | $10K | — | $10K | 2.28% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | PO BOX 896620 CHARLOTTE, NC 282896620 | METROPOLITAN LIFE INSURANCE COMPANY | $8K | $874 | $8K | 13.11% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFIT GRP INC | 5110 N 40TH ST STE 234 PHOENIX, AZ 850182151 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $668 | $4K | 6.21% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | PO BOX 896620 CHARLOTTE, NC 282896620 | SAFEGUARD HEALTH PLANS, INC., A TEXAS CORPORATION | $72 | $9 | $81 | 11.02% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFIT GRP INC | 5110 N 40TH ST STE 234 PHOENIX, AZ 850182151 | SAFEGUARD HEALTH PLANS, INC., A TEXAS CORPORATION | $36 | $7 | $43 | 5.85% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | PO BOX 896620 CHARLOTTE, NC 282896620 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $68 | $8 | $76 | 12.88% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFIT GRP INC | 5110 N 40TH ST STE 234 PHOENIX, AZ 850182151 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $34 | $7 | $41 | 6.95% |
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 | 368 | 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) | 368 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF TEXAS | 378 | $455K |
| Dental(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 554 | $66K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 554 | $64K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 554 | $64K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 554 | $64K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 554 | $64K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 554 | $64K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 554 | — |
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.