| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WELLS FARGO INSURANCE SERVICES3 | 21250 HAWTHORNE BLVD STE 600 TORRANCE, CA 90503 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $8K | $8K | 1.11% |
| PETER J MACE3 | 5775 D GLENRIDGE DR STE 350 ATLANTA, GA 30328 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $29K | $0 | $29K | 7.17% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SVCS USA, INC TORRA | 21250 HAWTHORNE BLVD STE 600 TORRANCE, CA 90503 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $13K | $494 | $13K | 3.33% |
| HODGES-MACE BENEFIT GRP3 Filed as: HODGES-MACE BENEFTIS GRP | 5775-D GLENRIDGE DR NE STE 350 ATLANTA, GA 30328 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $2K | $2K | 0.46% |
| WELLS FARGO INSURANCE SERVICES3 | 21250 HAWTHORNE BLVD STE 600 TORRANCE, CA 90503 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $3K | $3K | 1.02% |
| WELLS FARGO INSURANCE SERVICES3 | 21250 HAWTHORNE BLVD STE 600 TORRANCE, CA 90503 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $3K | $3K | 1.08% |
| PETER J MACE3 | 5775 D GLENRIDGE DR STE 350 ATLANTA, GA 30328 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $19K | $0 | $19K | 11.77% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SVCS USA, INC | 21250 HAWTHORNE BLVD. STE 600 TORRANCE, CA 90503 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $9K | $0 | $9K | 5.51% |
| HODGES-MACE BENEFITS GRP INC3 | 5775-D GLENRIDGE DR NE STE 350 ATLANTA, GA 30328 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $0 | $1K | 0.86% |
| WELLS FARGO INSURANCE SERVICES3 | 21250 HAWTHORNE BLVD STE 600 TORRANCE, CA 90503 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $1K | $1K | 1.07% |
| WELLS FARGO INSURANCE SERVICES3 | 21250 HAWTHORNE BLVD. STE 600 TORRANCE, CA 90503 | FIDELITY SECURITY LIFE | $8K | — | $8K | 7.50% |
| WELLS FARGO INSURANCE SERVICES3 | 21250 HAWTHORNE BLVD STE 600 TORRANCE, CA 90503 | CIGNA LIFE INSURANCE CO OF NEW YORK | — | $149 | $149 | 0.98% |
| PETER J MACE3 | 5775 D GLENRIDGE DR STE 350 ATLANTA, GA 30328 | FIRST UNUM LIFE INSURANCE COMPANY | $2K | $0 | $2K | 14.32% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SVCS USA, INC | 21250 HAWTHORNE BLVD. STE 600 TORRANCE, CA 90503 | FIRST UNUM LIFE INSURANCE COMPANY | $887 | $0 | $887 | 6.13% |
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 | 2,215 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 62 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 2,277 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 879 | $4.4M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (CIGNA) | 1,877 | $1.7M |
| Vision | VISION SERVICE PLAN | 1,615 | $217K |
| Life insurance(3 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,215 | $866K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,456 | $305K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,070 | $327K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 879 | $4.4M |
| Other(4 contracts, 4 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,215 | $658K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,215 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.