| 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 | — | $14K | $14K | 2.07% |
| PETER J MACE3 | 5775 E GLENRIDGE DR STE STE 500 ATLANTA, GA 30328 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $15K | $0 | $15K | 4.79% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 21250 HAWTHORNE BLVD 6TH FLOOR TORRANCE, CA 90503 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | $118 | $8K | 2.58% |
| WELLS FARGO INSURANCE SERVICES3 | 21250 HAWTHORNE BLVD STE 600 TORRANCE, CA 90503 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $6K | $6K | 2.13% |
| WELLS FARGO INSURANCE SERVICES3 | 21250 HAWTHORNE BLVD STE 600 TORRANCE, CA 90503 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $5K | $5K | 2.05% |
| PETER J MACE3 | 5775 E GLENRIDGE DR STE 500 ATLANTA, GA 30328 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $4K | — | $4K | 3.07% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 21250 HAWTHORNE BLVD 6TH FLOOR TORRANCE, CA 90503 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 1.41% |
| HODGES-MACE BENEFITS GRP INC3 Filed as: HODGES-MACE BENEFITS GRP | 5775 E GLENRIDGE DR STE 500 ATLANTA, GA 30328 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $224 | — | $224 | 0.17% |
| WELLS FARGO INSURANCE SERVICES3 | 21250 HAWTHORNE BLVD STE 600 TORRANCE, CA 90503 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $2K | $2K | 2.23% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 21250 HAWTHORNE BLVD STE 600 TORRANCE, CA 90503 | FIDELITY SECURITY LIFE | $5K | $0 | $5K | 7.50% |
| WELLS FARGO INSURANCE SERVICES3 | 21250 HAWTHORNE BLVD STE 600 TORRANCE, CA 90503 | CIGNA LIFE INSURANCE CO OF NEW YORK | — | $268 | $268 | 1.74% |
| PETER J MACE3 | 5775 E GLENRIDGE DR STE 500 ATLANTA, GA 30328 | FIRST UNUM INSURANCE COMPANY | $360 | — | $360 | 3.26% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 21250 HAWTHORNE BLVD STE 600 TORRANCE, CA 90503 | FIRST UNUM INSURANCE COMPANY | $154 | — | $154 | 1.39% |
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 | 2,218 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 26 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 2,244 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 649 | $3.4M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,707 | $1.5M |
| Vision | VISION SERVICE PLAN | 1,596 | $197K |
| Life insurance(3 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,218 | $797K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,587 | $267K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,089 | $284K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 649 | $3.4M |
| Other(4 contracts, 4 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,218 | $491K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,218 | — |
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.