| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WORTHAM SAN ANTONIO INC3 Filed as: WORTHAM-FORT WORTH INC. | 1600 W 7TH STREET SUITE 100 FORT WORTH, TX 76102 | SUN LIFE ASSURANCE COMPANY OF CANADA | $9K | $0 | $9K | 1.13% |
| WORTHAM SAN ANTONIO INC3 Filed as: WORTHAM-FORT WORTH INC. | 1600 W 7TH STREET SUITE 100 FORT WORTH, TX 76102 | SUN LIFE ASSURANCE COMPANY OF CANADA | $6K | $0 | $6K | 0.91% |
| WORTHAM SAN ANTONIO INC3 Filed as: WORTHAM-FORT WORTH INC. | 1600 W 7TH STREET SUITE 100 FORT WORTH, TX 76102 | SUN LIFE ASSURANCE COMPANY OF CANADA | $9K | $0 | $9K | 2.26% |
| WORTHAM SAN ANTONIO INC3 Filed as: WORTHAM FORT WORTH, INC. | 1600 W 7TH STREET FORT WORTH, TX 76102 | UNITEDHEALTHCARE INSURANCE | $31K | $0 | $31K | 9.87% |
| PETER J MACE3 | 5775 D GLENRIDGE DR. SUITE 350 ATLANTA, GA 30328 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $130K | $0 | $130K | 67.03% |
| HODGES-MACE BENEFITS GRP INC3 Filed as: HODGES-MACE BENEFITS GROUP, INC. | 5775-D GLENRIDGE DR. NE SUITE 350 ATLANTA, GA 30328 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $24K | $24K | 12.20% |
| PETER J MACE3 | 5775 D GLENRIDGE DR. SUITE 350 ATLANTA, GA 30328 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $33K | $0 | $33K | 58.33% |
| HODGES-MACE BENEFITS GRP INC3 Filed as: HODGES - MACE BENEFITS GROUP | 5775-D GLENRIDGE DRIVE NE SUITE 350 ATLANTA, GA 30328 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $18K | $8K | $26K | 44.96% |
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 | 3,539 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 43 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 3,582 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | UNITEDHEALTHCARE INSURANCE | 6,146 | $312K |
| Life insurance(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 3,539 | $733K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 3,539 | $788K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 3,539 | $384K |
| Other(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 3,539 | $869K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 6,146 | — |
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.