| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 3111 CAMINO DEL RIO N STE 1100 SAN DIEGO, CA 92108 | BLUE SHIELD OF CA, CALIFORNIA PHYSICIANS' SERVICE | — | $89K | $89K | 3.36% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 750 B STREET SUITE 2400 SAN DIEGO, CA 921012476 | KAISER FOUNDATION HEALTH PLAN INC | $42K | — | $42K | 2.92% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | PO BOX 896620 CHARLOTTE, NC 282896620 | METROPOLITAN LIFE INSURANCE COMPANY | $25K | $8K | $33K | 11.82% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 750 B STREET SUITE 2400 SAN DIEGO, CA 921012476 | KAISER FOUNDATION HEALTH PLAN INC | $8K | — | $8K | 3.16% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 5446 THORNWOOD DR SUITE 200 SAN JOSE, CA 95123 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | — | $5K | 10.00% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 2211 7TH AVE SOUTH BIRMINGHAM, AL 35233 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $3K | $3K | 5.00% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | PO BOX 896620 CHARLOTTE, NC 28289 | VISION SERVICE PLAN | $2K | — | $2K | 4.20% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 5446 THORNWOOD DR SUITE 200 SAN JOSE, CA 95123 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 10.00% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 2211 7TH AVE SOUTH BIRMINGHAM, AL 35233 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 4.08% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 3111 CAMINO DEL RIO N STE 1100 SAN DIEGO, CA 92108 | BLUE SHIELD OF CALIFORNIA LIFE HEALTH INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 5446 THORNWOOD DR SUITE 200 SAN JOSE, CA 95123 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 2211 7TH AVE SOUTH BIRMINGHAM, AL 35233 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $554 | $554 | 3.45% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 5446 THORNWOOD DR SUITE 200 SAN JOSE, CA 95123 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 10.00% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 2211 7TH AVE SOUTH BIRMINGHAM, AL 35233 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $676 | $676 | 5.16% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 5446 THORNWOOD DR SUITE 200 SAN JOSE, CA 95123 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $868 | — | $868 | 10.01% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 2211 7TH AVE SOUTH BIRMINGHAM, AL 35233 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $288 | $288 | 3.32% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 5446 THORNWOOD DR SUITE 200 SAN JOSE, CA 95123 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $248 | — | $248 | 9.98% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES, INC. | 2211 7TH AVE SOUTH BIRMINGHAM, AL 35233 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $115 | $115 | 4.63% |
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 | 665 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 9 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 680 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 4 carriers) | BLUE SHIELD OF CA, CALIFORNIA PHYSICIANS' SERVICE | 289 | $4.8M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 1,227 | $278K |
| Vision | VISION SERVICE PLAN | 282 | $40K |
| Life insurance(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 385 | $73K |
| Short-term disability(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 50 | $25K |
| Long-term disability(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 273 | $47K |
| Prescription drug | BLUE SHIELD OF CA, CALIFORNIA PHYSICIANS' SERVICE | 289 | $2.6M |
| Other(4 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 385 | $107K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,227 | — |
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."
No prospect flags tripped on this filing.