| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS | 3400 OVERTON PARK DRIVE SUITE 300 ATLANTA, GA 30339 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $12K | — | $12K | 0.78% |
| MCGRIFF INSURANCE SERVICES INC3 | EB COMMISSION P O BOX 896620 CHARLOTTE, NC 28289 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $89K | $7K | $97K | 16.25% |
| PLANSOURCE BENEFITS ADMINISTRATION3 Filed as: PLANSOURCE BENEFIT ADMIN | P O BOX 1313 ORLANDO, FL 32802 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 0.50% |
| MCGRIFF INSURANCE SERVICES INC3 | EB COMMISSION P O BOX 896620 CHARLOTTE, NC 28289 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $30K | $2K | $32K | 16.25% |
| PLANSOURCE BENEFITS ADMINISTRATION3 Filed as: PLANSOURCE BENEFIT ADMIN | P O BOX 1313 ORLANDO, FL 32802 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $996 | — | $996 | 0.50% |
| HODGES-MACE BENEFITS GRP INC3 Filed as: HODGES MACE BENEFITS GROUP | 3350 RIVERWOOD PARKWAY SUITE 80 ATLANTA, GA 30339 | UNUM LIFE INSURANCE COMPAMY OF AMERICA | $57K | $9K | $66K | 40.64% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INSURANCE SERVICE | 700 W 47TH STREET SUITE 1100 KANSAS CITY, MO 64112 | UNUM LIFE INSURANCE COMPAMY OF AMERICA | — | $1K | $1K | 0.78% |
| PLANSOURCE BENEFITS ADMINISTRATION3 Filed as: PLANSOURCE BENEFIT ADMIN | P O BOX 1313 ORLANDO, FL 32802 | UNUM LIFE INSURANCE COMPAMY OF AMERICA | $802 | — | $802 | 0.50% |
| HODGES-MACE BENEFITS GRP INC3 Filed as: HODGES MACE BENEFITS GROUP | 3350 RIVERWOOD PARKWAY SUITE 80 ATLANTA, GA 30339 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $5K | $392 | $6K | 8.94% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INSURANCE SERVICE | 700 W 47TH STREET SUITE 1100 KANSAS CITY, MO 64112 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $810 | — | $810 | 1.24% |
| PLANSOURCE BENEFITS ADMINISTRATION3 Filed as: PLANSOURCE BENEFIT ADMIN | P O BOX 1313 ORLANDO, FL 32802 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $327 | — | $327 | 0.50% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE | EB COMMISSION P O BOX 896620 CHARLOTTE, NC 28299 | METROPOLITAN PROPERTY AND CASUALTY INSURANCE CO | $4K | $308 | $4K | 11.03% |
| MCGRIFF INSURANCE SERVICES INC3 | 3400 OVERTON PARK DRIVE SUITE 300 ATLANTA, GA 30339 | METROPOLITAN PROPERTY AND CASUALTY INSURANCE CO | $758 | $586 | $1K | 3.81% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES | 12725 MORRIS ROAD EXT SUITE 200 ALPHARETTA, GA 30004 | METROPOLITAN PROPERTY AND CASUALTY INSURANCE CO | — | $79 | $79 | 0.22% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES | EB COMMISSION P O BOX 896620 CHARLOTTE, NC 28289 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $265 | $2K | 11.80% |
| PLANSOURCE BENEFITS ADMINISTRATION3 Filed as: PLANSOURCE BENEFIT ADMIN | P O BOX 1313 ORLANDO, FL 32802 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $106 | — | $106 | 0.54% |
| MCGRIFF INSURANCE SERVICES INC3 | EB COMMISSION P O BOX 896620 CHARLOTTE, NC 28289 | FIRST UNUM LIFE INSURANCE COMPANY | $1K | $93 | $1K | 17.14% |
| PLANSOURCE BENEFITS ADMINISTRATION3 Filed as: PLANSOURCE BENEFIT ADMIN | P O BOX 1313 ORLANDO, FL 32802 | FIRST UNUM LIFE INSURANCE COMPANY | $37 | — | $37 | 0.52% |
| MCGRIFF INSURANCE SERVICES INC3 | EB COMMISSION P O BOX 896620 CHARLOTTE, NC 28289 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $338 | $42 | $380 | 11.23% |
| PLANSOURCE BENEFITS ADMINISTRATION3 Filed as: PLANSOURCE BENEFIT ADMIN | P O BOX 1313 ORLANDO, FL 32802 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $17 | — | $17 | 0.50% |
| HODGES-MACE BENEFITS GRP INC3 Filed as: HODGES MACE BENEFITS GROUP | 3350 RIVERWOOD PARKWAY SUITE 80 ATLANTA, GA 30339 | FIRST UNUM LIFE INSURANCE COMPANY | $95 | — | $95 | 4.71% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INSURANCE SERVICE | 700 W 47TH STREET SUITE 1100 KANSAS CITY, MO 64112 | FIRST UNUM LIFE INSURANCE COMPANY | $29 | — | $29 | 1.44% |
| PLANSOURCE BENEFITS ADMINISTRATION3 Filed as: PLANSOURCE BENEFIT ADMIN | P O BOX 1313 ORLANDO, FL 32802 | FIRST UNUM LIFE INSURANCE COMPANY | $10 | — | $10 | 0.50% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 CLAIMS ADMIN | Non-monetary compensation; Claims processing; Participant communication; Contract Administrator; Named fiduciary; Direct payment from the plan; Other services; Float revenue Service code 12 | — | $858K |
| MCGRIFF SEIBELS AND WILLIAMS EIN 20-0468966 BROKER | Insurance services; Insurance agents and brokers Service code 22 | — | $73K |
| CIGNA | Named fiduciary; Float revenue; Claims processing; Non-monetary compensation; Contract Administrator; Other services; Direct payment from the plan; Participant communication 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 | 1,102 | 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) | 1,102 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1,751 | $1.5M |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1,751 | $1.5M |
| Life insurance(4 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,890 | $863K |
| Short-term disability(3 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,890 | $619K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,890 | $596K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1,751 | $1.5M |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1,751 | $1.5M |
| Other(7 contracts, 5 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,890 | $1.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,890 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.