| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 470 PARK AVE SOUTH FLOOR 6 NEW YORK, NY 10016 | HARTFORD LIFE AND ACCIDENT | — | $1K | $1K | 0.22% |
| USI INSURANCE SERVICES LLC3 | 21250 HAWTHORNE BLVD. STE 380 TORRANCE, CA 90503 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $6K | $6K | 1.43% |
| STEVEN RAY GRIFFIN3 | 2000 MORRIS AVE. STE 1400 BIRMINGHAM, AL 35203 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $67K | $11K | $79K | 23.54% |
| USI INSURANCE SERVICES LLC3 | 21700 OXNARD ST. STE 1200 WOODLAND HILLS, CA 91367 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $29K | $2K | $31K | 9.44% |
| USI INSURANCE SERVICES LLC3 | 21250 HAWTHORNE BLVD. 6TH FLOOR TORRANCE, CA 90503 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $555 | $4 | $559 | 0.17% |
| PETER J MACE3 Filed as: PETER J. MACE | 5775 E. GLENRIDGE DR. STE 500 ATLANTA, GA 30328 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $285 | — | $285 | 0.09% |
| UAI INSURANCE SERVICES LLC3 | 21250 HAWTHORNE BLVD. STE 380 TORRANCE, CA 90503 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $4K | $4K | 1.63% |
| STEVEN RAY GRIFFIN3 | 2000 MORRIS AVE. STE 1400 BIRMINGHAM, AL 35203 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $46K | $6K | $52K | 32.48% |
| USI INSURANCE SERVICES LLC3 | 21700 OXNARD ST. STE 1200 WOODLAND HILLS, CA 91367 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $20K | $1K | $21K | 13.16% |
| PETER J MACE3 Filed as: PETER J. MACE | 5775 E. GLENRIDGE DR. STE 500 ATLANTA, GA 30328 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $3K | — | $3K | 1.81% |
| USI INSURANCE SERVICES LLC3 | 21250 HAWTHORNE BLVD. 6TH FLOOR TORRANCE, CA 90503 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 0.82% |
| HODGES-MACE BENEFITS GRP INC3 | 5775 E. GLENRIDGE DR. STE 500 ATLANTA, GA 30328 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $131 | — | $131 | 0.08% |
| USI INSURANCE SERVICES LLC3 | 21250 HAWTHORNE BLVD. STE 380 TORRANCE, CA 90503 | CIGNA LIFE INSURANCE CO OF NEW YORK | — | $562 | $562 | 1.52% |
| STEVEN RAY GRIFFIN3 | 2000 MORRIS AVE. STE 1400 BIRMINGHAM, AL 35203 | FIRST UNUM LIFE INSURANCE COMPANY | $8K | — | $8K | 34.79% |
| USI INSURANCE SERVICES LLC3 | 21700 OXNARD ST. STE 1200 WOODLAND HILLS, CA 91367 | FIRST UNUM LIFE INSURANCE COMPANY | $3K | — | $3K | 14.91% |
| PETER J MACE3 Filed as: PETER J. MACE | 5775 E. GLENRIDGE DR. STE 500 ATLANTA, GA 30328 | FIRST UNUM LIFE INSURANCE COMPANY | $364 | — | $364 | 1.57% |
| USI INSURANCE SERVICES LLC3 | 21250 HAWTHORNE BLVD. STE 600 TORRANCE, CA 90503 | FIRST UNUM LIFE INSURANCE COMPANY | $156 | — | $156 | 0.67% |
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 | 2,337 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 61 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 2,398 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC. | 600 | $3.2M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,653 | $1.4M |
| Vision | VISION SERVICE PLAN | 1,569 | $190K |
| Life insurance(3 contracts, 3 carriers) | HARTFORD LIFE AND ACCIDENT | 2,227 | $808K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,574 | $252K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,337 | $418K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC. | 600 | $3.2M |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,310 | $371K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,337 | — |
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.