| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 750 B STREET SUITE 2400 SAN DIEGO, CA 921012476 | KAISER FOUNDATION HEALTH PLAN, INC. | $59K | — | $59K | 2.91% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 4480 WILLOW ROAD SUITE 110 PLEASANTON, CA 945888519 | SUTTER HEALTH PLAN | $23K | — | $23K | 5.00% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 7701 AIRPORT CENTER DRIVE SUITE 1800 GREENSBORO, NC 27409 | DELTA | $17K | — | $17K | 10.00% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | PO BOX 896620 CHARLOTTE, NC 282896620 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 6.78% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 4480 WILLOW ROAD SUITE 110 PLEASANTON, CA 94588 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | — | $1K | 3.98% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 7701 AIRPORT CENTER DRIVE SUITE 1800 GREENSBORO, NC 27409 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $1K | $1K | 3.27% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | PO BOX 896620 CHARLOTTE, NC 282896620 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | — | $1K | 5.81% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 4480 WILLOW ROAD SUITE 110 PLEASANTON, CA 94588 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $821 | — | $821 | 3.69% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 7701 AIRPORT CENTER DRIVE SUITE 1800 GREENSBORO, NC 27409 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $728 | $728 | 3.27% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | PO BOX 896620 CHARLOTTE, NC 282896620 | VISION SERVICE PLAN | $875 | — | $875 | 6.48% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | PO BOX 896620 CHARLOTTE, NC 282896620 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | — | $1K | 11.80% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 7701 AIRPORT CENTER DRIVE SUITE 1800 GREENSBORO, NC 27409 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $320 | $320 | 3.48% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 4480 WILLOW ROAD SUITE 110 PLEASANTON, CA 94588 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $294 | — | $294 | 3.20% |
| MASOLI LEGACY LLC4 | 588 ALEXIS CIRCLE DALY CITY, CA 94014 | PRE-PAID LEGAL SERVICES, INC. DBA LEGAL SHIELD | $764 | — | $764 | 13.95% |
| LISA L BASS4 | 16973 BRIDGETON LANE HUNTERSVILLE, NC 28078 | PRE-PAID LEGAL SERVICES, INC. DBA LEGAL SHIELD | $241 | — | $241 | 4.40% |
| PARRISH & ASSOCIATES4 | 4959 MEADOW BROOK ROAD BIRMINGHAM, AL 35242 | PRE-PAID LEGAL SERVICES, INC. DBA LEGAL SHIELD | $41 | — | $41 | 0.75% |
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 | 199 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 203 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 283 | $2.5M |
| Dental | DELTA | 210 | $167K |
| Vision | VISION SERVICE PLAN | 92 | $14K |
| Life insurance(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 199 | $31K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 200 | $35K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 283 | $2.5M |
| Other(4 contracts, 3 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 230 | $52K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 283 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.