| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | PO BOX 730054 DALLAS, TX 75373 | AETNA LIFE INSURANCE CO. | — | $4K | $4K | 2.03% |
| USI INSURANCE SERVICES LLC3 | 21250 HAWTHORNE BLVD 6TH FLOOR TORRANCE, CA 90503 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $2K | $5K | 7.34% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE | 16220 N SCOTTSDALE RD STE 600 SCOTTSDALE, AZ 85254 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $400 | $4K | 6.16% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | 16220 N SCOTTSDALE RD STE 600 SCOTTSDALE, AZ 85254 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $9K | $872 | $10K | 19.59% |
| HODGES-MACE BENEFITS GRP INC3 Filed as: HODGES-MACE BENEFITS GRP | 3350 RIVERWOOD PARKWAY STE 80 ATLANTA, GA 30339 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $35 | — | $35 | 0.07% |
| 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 | $347 | $3K | 7.06% |
| AON CONSULTING INC3 Filed as: CUSTOM BENEFIT PROGRAMS AN AON CO. | 897 12TH ST HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 2.88% |
| HODGES-MACE BENEFITS GRP INC3 Filed as: HODGES-MACE BENEFITS GRP | 3350 RIVERWOOD PARKWAY STE 80 ATLANTA, GA 30339 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $327 | — | $327 | 0.80% |
| SULLIVANCURTISMONROE INS SVCS LLC3 | 1920 MAIN ST STE 600 IRVINE, CA 92614 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $315 | — | $315 | 0.77% |
| USI INSURANCE SERVICES LLC3 | 21250 HAWTHORNE BLVD 6TH FLOOR TORRANCE, CA 90503 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $7 | — | $7 | 0.02% |
| USI INSURANCE SERVICES LLC3 | 21250 HAWTHORNE BLVD 6TH FLOOR TORRANCE, CA 90503 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $713 | $3K | 12.56% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE | 16220 N SCOTTSDALE RD STE 600 SCOTTSDALE, AZ 85254 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $106 | $1K | 6.05% |
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 | 3,899 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 10 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 195 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 4,104 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | KAISER FOUNDATION HEALTH PLAN, INC. | 759 | $6.9M |
| Dental | AETNA LIFE INSURANCE CO. | 1,486 | $200K |
| Vision(2 contracts, 2 carriers) | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO | 3,137 | $164K |
| Life insurance(4 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 4,534 | $2.1M |
| Short-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 4,534 | $2.0M |
| Long-term disability(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 4,534 | $2.1M |
| Other(6 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 4,534 | $2.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,534 | — |
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."
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.