| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 3475 PIEDMONT ROAD, SUITE 800 ATLANTA, GA 30305 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $147K | $53K | $200K | 8.96% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | PO BOX 201503 DALLAS, TX 75320 | HARTFORD LIFE AND ACCIDENT | $35K | — | $35K | 15.00% |
| ADMINISTRATIVE SOLUTIONS INC.3 Filed as: ADMINISTRATIVE SOLUTIONS INC | 11373 SOUTHBRIDGE PARKWAY ALPHARETTA, GA 30022 | HARTFORD LIFE AND ACCIDENT | $15 | — | $15 | 0.01% |
| HODGES-MACE BENEFITS GRP INC3 Filed as: HODGES MACE BENEFITS GROUP, INC. | 5775 D GLENRIDGE DRIVE NE SUITE 350 ATLANTA, GA 30328 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $59K | $10K | $69K | 58.37% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 3475 PIEDMONT ROAD NE, SUITE 800 ATLANTA, GA 30305 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $20K | $2K | $22K | 18.10% |
| HODGES-MACE BENEFITS GRP INC3 Filed as: HODGES MACE BENEFITS GROUP, INC. | 5775 D GLENRIDGE DRIVE NE SUITE 350 ATLANTA, GA 30328 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $25K | $10K | $35K | 43.47% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 3475 PIEDMONT ROAD NE, SUITE 800 ATLANTA, GA 30305 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $12K | $4K | $16K | 20.17% |
| PETER J MACE3 Filed as: PETER J. MACE | 5775 D GLENRIDGE DRIVE, SUITE 350 ATLANTA, GA 30328 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $12K | — | $12K | 14.23% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 600 HIGHWAY 169 SOUTH, SUITE 1200 SAINT LOUIS, MN 55426 | EYEMED | $10K | — | $10K | 13.32% |
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 | 1,093 | 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) | 1,097 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,825 | $2.2M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,825 | $2.2M |
| Vision | EYEMED | 1,263 | $76K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 1,135 | $236K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 352 | $81K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 1,135 | $236K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,825 | $2.2M |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 1,135 | $355K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,825 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.