| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN INC | — | $505 | $505 | 0.02% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | HARTFORD LIFE AND ACCIDENT | — | $11K | $11K | 2.13% |
| USI INSURANCE SERVICES LLC3 | 21250 HAWTHORNE BLVD. SUITE 380 TORRANCE, CA 90503 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $11K | $11K | 2.57% |
| USI INSURANCE SERVICES LLC3 | 21250 HAWTHORNE BLVD. SUITE 380 TORRANCE, CA 90503 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $6K | $6K | 1.94% |
| USI INSURANCE SERVICES LLC3 | 21700 OXNARD ST STE 1200 WOODLAND HILLS, CA 91367 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $24 | $6K | 2.65% |
| STEVEN RAY GRIFFIN3 | 2000 MORRIS AVE STE 1400 BIRMINGHAM, AL 35203 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | -$61 | $4K | 1.75% |
| USI INSURANCE SERVICES LLC3 | 21250 HAWTHORNE BLVD. 6TH FLOOR TORRANCE, CA 90503 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $417 | $0 | $417 | 0.17% |
| HODGES-MACE BENEFITS GRP INC3 Filed as: HODGES-MACE BENEFITS GRP | 3350 RIVERWOOD PARKWAY STE 80 ATLANTA, GA 30339 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $59 | — | $59 | 0.02% |
| HODGES-MACE BENEFITS GRP INC3 Filed as: HODGES-MACE BENEFITS GRP | 3350 RIVERWOOD PARKWAY STE 80 ATLANTA, GA 30339 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 1.80% |
| STEVEN RAY GRIFFIN3 | 2000 MORRIS AVE STE 1400 BIRMINGHAM, AL 35203 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 1.70% |
| USI INSURANCE SERVICES LLC3 | 21250 HAWTHORNE BLVD. 6TH FLOOR TORRANCE, CA 90503 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $890 | — | $890 | 0.78% |
| USI INSURANCE SERVICES LLC3 | 21700 OXNARD ST STE 1200 WOODLAND HILLS, CA 91367 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $830 | — | $830 | 0.73% |
| USI INSURANCE SERVICES LLC3 | 21250 HAWTHORNE BLVD. SUITE 380 TORRANCE, CA 90503 | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | — | $1K | $1K | 1.45% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 21250 HAWTHORNE BLVD. SUITE 380 TORRANCE, CA 90503 | HARTFORD LIFE AND ACCIDENT | — | $1K | $1K | 1.51% |
| STEVEN RAY GRIFFIN3 | 2000 MORRIS AVE STE 1400 BIRMINGHAM, AL 35203 | FIRST UNUM LIFE INSURANCE COMPANY | $288 | — | $288 | 1.79% |
| HODGES-MACE BENEFITS GRP INC3 Filed as: HODGES-MACE BENEFITS GRP | 3350 RIVERWOOD PARKWAY STE 80 ATLANTA, GA 30339 | FIRST UNUM LIFE INSURANCE COMPANY | $275 | — | $275 | 1.71% |
| USI INSURANCE SERVICES LLC3 | 21700 OXNARD ST STE 1200 WOODLAND HILLS, CA 91367 | FIRST UNUM LIFE INSURANCE COMPANY | $124 | — | $124 | 0.77% |
| USI INSURANCE SERVICES LLC3 | 21250 HAWTHORNE BLVD. 6TH FLOOR TORRANCE, CA 90503 | FIRST UNUM LIFE INSURANCE COMPANY | $118 | — | $118 | 0.73% |
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 | 2,034 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 22 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 2,056 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 475 | $2.5M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,548 | $1.1M |
| Vision | VISION SERVICE PLAN | 1,479 | $180K |
| Life insurance(3 contracts, 3 carriers) | HARTFORD LIFE AND ACCIDENT | 2,034 | $665K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,463 | $299K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,357 | $423K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 475 | $2.5M |
| Other(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,630 | $414K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,630 | — |
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.