| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 1000 EAST WARRENVILLE ROAD SUITE 230 NAPERVILLE, IL 60563 | BLUE CROSS OF CALIFORNIA | $127K | $0 | $127K | 4.30% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD SUITE 600 GLENDALE, CA 91203 | KAISER FOUNDATION HEALTH PLAN INC | $64K | $0 | $64K | 3.65% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE 14TH FLOOR ITASCA, IL 60143 | KAISER FOUNDATION HEALTH PLAN INC | $0 | $445 | $445 | 0.03% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD 6TH FLOOR GLENDALE, CA 91203 | AETNA LIFE INSURANCE COMPANY | $24K | $4K | $28K | 6.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD 6TH FLOOR GLENDALE, CA 91203 | TRANSAMERICA LIFE INSURANCE COMPANY | $13K | $0 | $13K | 16.66% |
| AMERICAN WORKSITE INS MKTG INC.3 Filed as: AMERICAN WORKSITE INS. MKTG., INC. | 1365 WEST VISTA WAY, SUITE 201 VISTA, CA 92083 | TRANSAMERICA LIFE INSURANCE COMPANY | $792 | $0 | $792 | 1.04% |
| ASHBROOK CLEVIDENCE, INC.3 | WEST 3000 MACARTHUR BOULVARD SUITE 320 SANTA ANA, CA 92704 | TRANSAMERICA LIFE INSURANCE COMPANY | $34 | $0 | $34 | 0.04% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS SRVCS | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | TRANSAMERICA LIFE INSURANCE COMPANY | $22 | $0 | $22 | 0.03% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 9700 ORMSBY STATION ROAD, SUITE 200 LOUISVILLE, KY 40242 | TRANSAMERICA LIFE INSURANCE COMPANY | $3 | $0 | $3 | 0.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD 6TH FLOOR GLENDALE, CA 91203 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $1K | $5K | 10.17% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $1K | $1K | 2.02% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, SUITE 1000 ROLLING MEADOWS, IL 60008 | VISION SERVICE PLAN | $4K | $0 | $4K | 9.15% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | VISION SERVICE PLAN | $399 | $0 | $399 | 0.85% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | LEGAL CLUB | $897 | $0 | $897 | 18.90% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 5TH FLOOR ROLLING MEADOWS, IL 60006 | LEGAL CLUB | $666 | $0 | $666 | 14.03% |
| COMMON CENSUS, INC.3 | UNKNOWN WOODLAND HILLS, CA 91367 | LEGAL CLUB | $165 | $0 | $165 | 3.48% |
| AMERICAN WORKSITE INS. MARKETING3 | UNKNOWN WOODLAND HILLS, CA 91367 | LEGAL CLUB | $118 | $0 | $118 | 2.49% |
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 | 354 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 10 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 367 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 350 | $4.7M |
| Dental | AETNA LIFE INSURANCE COMPANY | 833 | $468K |
| Vision | VISION SERVICE PLAN | 344 | $47K |
| Life insurance(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 833 | $544K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 117 | $53K |
| Long-term disability | AETNA LIFE INSURANCE COMPANY | 833 | $468K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 350 | $4.7M |
| Other(3 contracts, 3 carriers) | AETNA LIFE INSURANCE COMPANY | 833 | $549K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 833 | — |
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."
No prospect flags tripped on this filing.