| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RUTHERFORD FINANCIAL SERVICES INC.3 Filed as: MEGRIFF, SEIBELS & WILLIAMS INC | 5605 GLENRIDGE DRIVE SUITE 300 ATLANTA, GA 303421374 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $41K | $0 | $41K | 7.52% |
| AON CONSULTING INC3 | 29840 NETWORK PLACE CHICAGO, IL 606731298 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $13K | $0 | $13K | 2.48% |
| RUTHERFORD FINANCIAL SERVICES INC.3 Filed as: MEGRIFF, SEIBELS & WILLIAMS INC. | 5605 GLENRIDGE DRIVE SUITE 300 ATLANTA, GA 303421374 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $42K | $0 | $42K | 11.63% |
| RUTHERFORD FINANCIAL SERVICES INC.3 Filed as: MEGRIFF, SEIBELS & WILLIAMS INC. | 5605 GLENRIDGE DRIVE SUITE 300 ATLANTA, GA 303421374 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $24K | $0 | $24K | 7.64% |
| RUTHERFORD FINANCIAL SERVICES INC.3 Filed as: MEGRIFF, SEIBELS & WILLIAMS INC. | 5605 GLENRIDGE DRIVE SUITE 300 ATLANTA, GA 303421374 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $32K | $0 | $32K | 11.64% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS & WILLIAMS | 5605 GLENRIDGE DRIVE, SUITE 300 ONE PREMIER PLAZA ATLANTA, GA 30342 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $3K | $0 | $3K | 2.97% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE EIN 59-1031071 CONSULTANT | Contract Administrator; Claims processing Service code 12 | — | $1.4M |
| MCGRIFF SEIBELS & WILIAMS CONSULTANT | Claims processing; Contract Administrator Service code 12 | 5605 GLENRIDGE DRIVE SUITE 300 ATLANTA, GA 30342 | $485K |
| METROPOLITAN LIFE INSURANCE COMPANY EIN 13-5581829 CONSULTANT | Claims processing; Contract Administrator Service code 12 | — | $87K |
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 | 2,720 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 37 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,757 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 5,316 | $952K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 408 | $102K |
| Vision | VISION SERVICE PLAN | 2,470 | $394K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 2,536 | $859K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 2,179 | $277K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 2,537 | $362K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 5,316 | $850K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 2,536 | $315K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,316 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.