| 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 | 0.64% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES | EB COMMISSION CHARLOTTE, NC 28289 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $3K | — | $3K | 0.15% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES | 3400 OVERTON PARK DRIVE SE SUITE 300 ATLANTA, GA 30339 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $57K | — | $57K | 16.34% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES | 3400 OVERTON PARK DRIVE SE SUITE 300 ATLANTA, GA 30339 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $57K | — | $57K | 17.35% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES | 3400 OVERTON PARK DRIVE SE SUITE 300 ATLANTA, GA 30339 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $29K | — | $29K | 17.40% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES | 3400 OVERTON PARK DR SE SUITE 300 ATLANTA, GA 30339 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $10K | — | $10K | 16.09% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES | 3400 OVERTON PARK DRIVE SE SUITE 300 ATLANTA, GA 30339 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $18K | — | $18K | 28.08% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE | EB COMMISSION P O BOX 896620 CHARLOTTE, NC 28289 | METROPOLITAN GENERAL INSURANCE COMPANY | $5K | $55 | $5K | 10.10% |
| MCGRIFF INSURANCE SERVICES INC3 | 12725 MORRIS ROAD EXT SUITE 200 ALPHARETTA, GA 30004 | METROPOLITAN GENERAL INSURANCE COMPANY | — | $540 | $540 | 1.01% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES | 3400 OVERTON PARK DRIVE SE SUITE 300 ATLANTA, GA 30339 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $13K | — | $13K | 28.00% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES | 3400 OVERTON PARK DRIVE SE SUITE 300 ATLANTA, GA 30339 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 15.79% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES | 3400 OVERTON PARK DRIVE SE SUITE 300 ATLANTA, GA 30339 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $8K | — | $8K | 42.13% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES | 3400 OVERTON PARK DRIVE SE SUITE 300 ATLANTA, GA 30339 | NEW YORK LIFE GROUP INSURANCE CO OF NY | $2K | — | $2K | 10.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INSUR SERV INC | 700 W 47TH STREET SUITE 1100 KANSAS CITY, MO 64112 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $265 | $2K | 12.07% |
| MCGRIFF INSURANCE SERVICES INC3 | EB COMMISSION P O BOX 896620 CHARLOTTE, NC 28289 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $854 | $635 | $1K | 11.14% |
| MCGRIFF INSURANCE SERVICES INC3 | EB COMMISSION P O BOX 896620 CHARLOTTE, NC 28289 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $121 | $24 | $145 | 1.08% |
| MCGRIFF INSURANCE SERVICES INC3 | P O BOX 896620 CHARLOTTE, NC 28289 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $1K | $1K | 17.57% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 CLAIMS ADMIN | Float revenue; Contract Administrator; Named fiduciary; Direct payment from the plan; Claims processing; Non-monetary compensation; Other services; Participant communication Service code 12 | — | $949K |
| MCGRIFF SEIBELS AND WILLIAMS EIN 20-0468966 BROKER | Insurance services; Insurance agents and brokers Service code 22 | — | $84K |
| CIGNA | Named fiduciary; Other services; Contract Administrator; Participant communication; Float revenue; Non-monetary compensation; Direct payment from the plan; Claims processing 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 | 1,303 | 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) | 1,303 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 2,011 | $1.9M |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 2,011 | $1.9M |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,303 | $326K |
| Short-term disability(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,303 | $351K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,303 | $165K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 2,011 | $1.9M |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 2,011 | $1.9M |
| Other(11 contracts, 4 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,303 | $631K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,011 | — |
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.