| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 21250 HAWTHORNE BOULEVARD SUITE 380 TORRANCE, CA 90503 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $15K | $15K | 1.61% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | HARTFORD LIFE AND ACCIDENT | $0 | $12K | $12K | 1.65% |
| USI INSURANCE SERVICES LLC3 | 21250 HAWTHORNE BOULEVARD SUITE 380 TORRANCE, CA 90503 | HARTFORD LIFE AND ACCIDENT | $0 | $2K | $2K | 0.21% |
| USI INSURANCE SERVICES LLC3 | 21250 HAWTHORNE BOULEVARD SUITE 600 TORRANCE, CA 90503 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $21K | $182 | $21K | 9.42% |
| STEVEN RAY GRIFFIN3 | 2000 MORRIS AVENUE, SUITE 1400 BIRMINGHAM, AL 35203 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $362 | $0 | $362 | 0.16% |
| USI INSURANCE SERVICES LLC3 | 21700 OXNARD STREET, SUITE 1200 WOODLAND HILLS, CA 91367 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $327 | $3 | $330 | 0.15% |
| HODGES-MACE BENEFITS GRP INC3 Filed as: HODGES-MACE BENEFITS GROUP | 3350 RIVERWOOD PARKWAY ATALNTA, GA 30339 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $61 | $0 | $61 | 0.03% |
| HODGES-MACE BENEFITS GRP INC3 Filed as: HODGES-MACE BENEFITS GROUP | 3350 RIVERWOOD PARKWAY ATALNTA, GA 30339 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 1.79% |
| STEVEN RAY GRIFFIN3 | 2000 MORRIS AVENUE, SUITE 1400 BIRMINGHAM, AL 35203 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 1.70% |
| USI INSURANCE SERVICES LLC3 | 21250 HAWTHORNE BOULEVARD SUITE 600 TORRANCE, CA 90503 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $747 | $0 | $747 | 0.78% |
| USI INSURANCE SERVICES LLC3 | 21700 OXNARD STREET, SUITE 1200 WOODLAND HILLS, CA 91367 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $703 | $0 | $703 | 0.73% |
| STEVEN RAY GRIFFIN3 | 2000 MORRIS AVENUE, SUITE 1400 BIRMINGHAM, AL 35203 | FIRST UNUM LIFE INSURANCE COMPANY | $277 | $0 | $277 | 1.68% |
| HODGES-MACE BENEFITS GRP INC3 Filed as: HODGES-MACE BENEFITS GROUP | 3350 RIVERWOOD PARKWAY ATALNTA, GA 30339 | FIRST UNUM LIFE INSURANCE COMPANY | $275 | $0 | $275 | 1.66% |
| USI INSURANCE SERVICES LLC3 | 21250 HAWTHORNE BOULEVARD SUITE 600 TORRANCE, CA 90503 | FIRST UNUM LIFE INSURANCE COMPANY | $197 | $0 | $197 | 1.19% |
| USI INSURANCE SERVICES LLC3 | 21700 OXNARD STREET, SUITE 1200 WOODLAND HILLS, CA 91367 | FIRST UNUM LIFE INSURANCE COMPANY | $119 | $0 | $119 | 0.72% |
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 | 1,952 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 13 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,965 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 431 | $2.5M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,488 | $1.1M |
| Vision | VISION SERVICE PLAN | 1,428 | $174K |
| Life insurance(3 contracts, 3 carriers) | HARTFORD LIFE AND ACCIDENT | 1,952 | $839K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,952 | $948K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,952 | $948K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 431 | $2.5M |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 1,952 | $950K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,952 | — |
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.