| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 21250 HAWTHORNE BLVD STE 600 TORRANCE, CA 90503 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO | $1 | — | $1 | 0.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVC WEST | 16220 N SCOTTSDALE RD STE 600 SCOTTSDALE, AZ 85254 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $9K | $675 | $9K | 14.14% |
| HODGES-MACE BENEFITS GRP INC3 Filed as: HODGES-MACE BENEFITS GRP | STE 80 3350 RIVERWOOD PARKWAY ATLANTA, GA 30339 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $551 | — | $551 | 0.83% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | 16220 N SCOTTSDALE RD STE 600 SCOTTSDALE, AZ 85254 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $688 | $4K | 6.30% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS | 897 12TH ST HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 2.27% |
| HODGES-MACE BENEFITS GRP INC3 Filed as: HODGES-MACE BENEFITS GRP | STE 80 3350 RIVERWOOD PARKWAY ATLANTA, GA 30339 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $433 | — | $433 | 0.74% |
| SULLIVANCURTISMONROE INS. SVCS.3 Filed as: SULLIVANCURTISMONROE INS SERVICES | 1920 MAIN ST STE 600 IRVINE, CA 92614 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $353 | — | $353 | 0.60% |
| USI INSURANCE SERVICES LLC3 | 21250 HAWTHORNE BLVD 6TH FLOOR TORRANCE, CA 90503 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $22 | — | $22 | 0.04% |
| USI INSURANCE SERVICES LLC3 | 21250 HAWTHORNE BLVD 6TH FLOOR TORRANCE, CA 90503 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $929 | $6K | 11.92% |
| USI INSURANCE SERVICES LLC3 | 21250 HAWTHORNE BLVD 6TH FLOOR TORRANCE, CA 90503 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $289 | $3K | 16.71% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 21250 HAWTHORNE BLVD STE 600 TORRANCE, CA 90503 | COMBINED INSURANCE COMPANY OF AMERICA | $1 | — | $1 | 0.05% |
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 | 3,503 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 15 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 3,520 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC | 704 | $6.7M |
| Dental | AETNA LIFE INSURANCE CO. | 1,551 | $221K |
| Vision(2 contracts, 2 carriers) | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO | 2,956 | $168K |
| Life insurance(4 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 4,053 | $1.8M |
| Short-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 4,053 | $1.7M |
| Long-term disability(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 4,053 | $1.7M |
| Other(6 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 4,286 | $1.9M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,286 | — |
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.