| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MCGRIFF INSURANCE SERVICES INC3 | 1104 AMHERST ST WINCHESTER, VA 22601 | BLUE CROSS OF CALIFORNIA | — | — | $0 | 0.00% |
| FBP INSURANCE SERVICES3 | 130 THEORY, STE 200 IRVINE, CA 926173065 | VISION SERVICE PLAN | $3K | — | $3K | 3.36% |
| MCGRIFF INSURANCE SERVICES INC3 | PO BOX 896620 CHARLOTTE, NC 28290 | VISION SERVICE PLAN | $1K | — | $1K | 1.24% |
| F.B.P. INSURANCE SERVICES, LLC3 | 130 THEORY STREET, SUITE 200 IRVINE, CA 92617 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $9K | $5K | $14K | 14.82% |
| F.B.P. INSURANCE SERVICES, LLC3 | 130 THEORY STREET, SUITE 200 IRVINE, CA 92617 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | $6K | $11K | 11.10% |
| F.B.P. INSURANCE SERVICES, LLC3 | 130 THEORY STREET, SUITE 200 IRVINE, CA 92617 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $10K | $7K | $17K | 19.26% |
| CHARLES D. BLOCK3 Filed as: CHARLES D BLOCK | 648 VILLAGE PARK DR UNIT 208 WILMINGTON, NC 28405 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $83 | $1K | 6.10% |
| MCGRIFF INSURANCE SERVICES INC3 | 414 GALLIMORE DAIRY ROAD STE F GREENSBORO, NC 27409 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $876 | — | $876 | 3.66% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS | 897 12TH ST HAMMONTON, NJ 08037 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $375 | $2 | $377 | 1.58% |
| JAMES H. VAN EPPS3 Filed as: JAMES VAN EPPS | 10930 CRABAPPLE ROAD, STE 206 ROSWELL, GA 30075 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $196 | — | $196 | 0.82% |
| F.B.P. INSURANCE SERVICES, LLC3 | 130 THEORY STREET, SUITE 200 IRVINE, CA 92617 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $1K | $3K | 16.93% |
| F.B.P. INSURANCE SERVICES, LLC3 | 130 THEORY STREET, SUITE 200 IRVINE, CA 92617 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $531 | $727 | $1K | 12.56% |
| CHARLES D. BLOCK3 Filed as: CHARLES D BLOCK | UNIT 208 648 VILLAGE PARK DR WILMINGTON, NC 28405 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $666 | $51 | $717 | 67.83% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS | 897 12TH ST HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $17 | $290 | $307 | 29.04% |
| MCGRIFF INSURANCE SERVICES INC3 | 414 GALLIMORE DAIRY ROAD SUITE F GREENSBORO, NC 27409 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $304 | — | $304 | 28.76% |
| JAMES H. VAN EPPS3 Filed as: JAMES VAN EPPS | 10930 CRABAPPLE RD, STE 206 ROSWELL, GA 30075 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $19 | — | $19 | 1.80% |
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 | 867 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 871 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 620 | $5.8M |
| Dental | AETNA LIFE INSURANCE CO. | 207 | $37K |
| Vision | VISION SERVICE PLAN | 467 | $103K |
| Life insurance(3 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 867 | $185K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 867 | $96K |
| Other(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 867 | $51K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 867 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.