| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 470 PARK AVE SOUTH FLOOR 6 NEW YORK, NY 10016 | THE HARTFORD | — | $33K | $33K | 7.96% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | 21250 HAWTHORNE BLVD., SUITE 600 TORRANCE, CA 90503 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $3K | $3K | 0.81% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | 21250 HAWTHORNE BLVD., SUITE 600 TORRANCE, CA 90503 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $3K | $3K | 1.05% |
| 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 | $10K | $95 | $10K | 3.94% |
| PETER J MACE3 Filed as: PETER J. MACE | 5775 E GLENRIDGE DR STE 500 ATLANTA, GA 30328 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $0 | $5K | 2.09% |
| STEVEN RAY GRIFFIN3 | 2000 MORRIS AVE STE 1400 BIRMINGHAM, AL 35203 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $78 | $0 | $78 | 0.03% |
| USI INSURANCE SERVICES LLC3 | P.O. BOX 62949 VIRGINIA BEACH, VA 23466 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $34 | $0 | $34 | 0.01% |
| HODGES-MACE BENEFITS GRP INC3 | 5775 E GLENRIDGE DR STE 500 ATLANTA, GA 30328 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $2 | $2 | 0.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | 21250 HAWTHORNE BLVD., SUITE 600 TORRANCE, CA 90503 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $7K | $7K | 4.06% |
| PETER J MACE3 Filed as: PETER J. MACE | 5775 E GLENRIDGE DR STE 500 ATLANTA, GA 30328 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $0 | $3K | 3.59% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 21250 HAWTHORNE BLVD., SUITE 600 TORRANCE, CA 90503 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $1K | $3K | 3.08% |
| 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 | $160 | $0 | $160 | 0.17% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | 21250 HAWTHORNE BLVD., SUITE 600 TORRANCE, CA 90503 | FIDELITY SECURITY LIFE | $4K | $0 | $4K | 7.50% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | 21250 HAWTHORNE BLVD., SUITE 600 TORRANCE, CA 90503 | CIGNA LIFE INSURANCE CO OF NEW YORK | — | $169 | $169 | 0.52% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | 21250 HAWTHORNE BLVD., SUITE 600 TORRANCE, CA 90503 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $1K | $1K | 4.28% |
| PETER J MACE3 Filed as: PETER J. MACE | 5775 E GLENRIDGE DR STE 500 ATLANTA, GA 30328 | FIRST UNUM LIFE INSURANCE COMPANY | $385 | $0 | $385 | 3.78% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | 21250 HAWTHORNE BLVD., SUITE 600 TORRANCE, CA 90503 | FIRST UNUM LIFE INSURANCE COMPANY | $165 | $0 | $165 | 1.62% |
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 | 2,195 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 21 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 2,216 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 620 | $2.8M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,600 | $1.4M |
| Vision | VISION SERVICE PLAN | 1,502 | $181K |
| Life insurance(4 contracts, 4 carriers) | THE HARTFORD | 2,060 | $698K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,465 | $279K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,216 | $387K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 620 | $2.8M |
| Other(4 contracts, 4 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,050 | $356K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,216 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.