| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MACE, PETER, J3 | 5775-E GLENRIDGE DRIVE SUITE 500 ATLANTA, GA 30328 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $83K | — | $83K | 53.52% |
| HODGES-MACE BENEFITS GRP INC3 | 5775 E GLENRIDGE DR STE 500 ATLANTA, GA 30328 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $14K | $14K | 9.28% |
| USI INSURANCE SERVICES LLC3 | 21250 HAWTHORNE BLVD 6TH FLOOR TORRANCE, CA 90503 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | $594 | $8K | 5.14% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ARIZONA INC | 16220 N SCOTTSDALE RD STE 600 SCOTTSDALE, AZ 85254 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $268 | $3K | 2.05% |
| MACE, PETER, J3 | 5775 E GLENRIDGE DR STE 500 ATLANTA, GA 30328 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $35K | — | $35K | 22.79% |
| USI INSURANCE SERVICES LLC3 | 21250 HAWTHORNE BLVD 6TH FLOOR TORRANCE, CA 90503 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $9K | $1K | $10K | 6.27% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ARIZONA INC | 16220 N SCOTTSDALE ROAD STE 600 SCOTTSDALE, AZ 85254 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $7K | $555 | $8K | 4.95% |
| CUSTOM BENEFITS PROGRAMS3 Filed as: CUSTOM BENEFIT PROGRAMS AN | AON COMPANY 897 12TH ST HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $5K | $2K | $6K | 4.03% |
| HODGES-MACE BENEFITS GRP INC3 Filed as: HODGES-MACE BENEFITS GRP INC. | 5775 E GLENRIDGE DR STE 500 ATLANTA, GA 30328 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $4K | $4K | 2.77% |
| SULLIVANCURTISMONROE INS SVCS LLC3 Filed as: SULLIVANCURTISMONROE INS. SVCS, LLC | 1920 MAIN ST STE 600 IRVINE, CA 92614 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $695 | — | $695 | 0.45% |
| SULLIVANCURTISMONROE INS SVCS LLC3 Filed as: SULLIVANCURTISMONROE INS. SVCS, LLC | 1920 MAIN ST STE 600 IRVINE, CA 92614 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $586 | — | $586 | 0.38% |
| USI INSURANCE SERVICES LLC3 | 21250 HAWTHORNE BLVD TORRANCE, CA 90503 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | $442 | $7K | 12.66% |
| USI INSURANCE SERVICES LLC3 | 21250 HAWTHORNE BLVD 6TH FLOOR TORRANCE, CA 90503 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $148 | $3K | 16.99% |
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 | 3,472 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 16 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 3,488 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 1,931 | $4.0M |
| Dental | AETNA LIFE INSURANCE CO. | 1,931 | $242K |
| Vision | EYEMED VISION CARE ON BEHALF OF COMBINED INS CO OF AMERICA | 2,700 | $152K |
| Life insurance(4 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 3,709 | $1.6M |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 3,709 | $1.4M |
| Long-term disability(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 3,709 | $1.5M |
| Other(5 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 3,709 | $1.8M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,709 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.