| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 2600 SOUTH TELEGRAPH ROAD SUITE 100 BLOOMFIELD HILLS, MI 48302 | KAISER FOUNDATION HEALTH PLAN, INC. | $36K | $0 | $36K | 3.98% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | FIRST UNUM LIFE INSURANCE COMPANY | $22K | $0 | $22K | 7.05% |
| CATHERINE MICHELLE DOBRATZ3 Filed as: CATHERINE M. DOBRATZ | 9903 EAST 150TH AVENUE BRIGHTON, CO 80602 | FIRST UNUM LIFE INSURANCE COMPANY | $16K | $0 | $16K | 5.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | FIRST UNUM LIFE INSURANCE COMPANY | $0 | $6K | $6K | 2.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2600 SOUTH TELEGRAPH ROAD SUITE 100 BLOOMFIELD HILLS, MI 48302 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $29K | $0 | $29K | 10.03% |
| CATHERINE MICHELLE DOBRATZ3 Filed as: CATHERINE M. DOBRATZ | 9903 EAST 150TH AVENUE BRIGHTON, CO 80602 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $7K | $0 | $7K | 5.19% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $5K | $0 | $5K | 3.43% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $0 | $1K | $1K | 0.99% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | VISION SERVICE PLAN | $2K | — | $2K | 4.21% |
| A SECURE YOU INC4 Filed as: A SECURE YOU, INC. | 63 SABLE RUN EAST AMHERST, NY 14051 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $2K | — | $2K | 12.35% |
| GALLAGHER BENEFIT SERVICES, INC.4 | 2850 GOLF ROAD, SUITE 1000 ROLLING MEADOWS, IL 60008 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $639 | $0 | $639 | 4.59% |
| GCG FINANCIAL LLC3 Filed as: AN ALERA GROUP AGENCY | 333 NORTH GLENOAKS BOULEVARD SUITE 410 BURBANK, CA 91502 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $130 | $0 | $130 | 0.93% |
| PATRICIA HERBERGER4 | 2601 LAKE ROAD RANSOMVILLE, NY 14131 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $20 | — | $20 | 0.14% |
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 | 485 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 485 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN, INC. | 69 | $905K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 440 | $290K |
| Vision | VISION SERVICE PLAN | 449 | $38K |
| Life insurance | FIRST UNUM LIFE INSURANCE COMPANY | 485 | $311K |
| Short-term disability | FIRST UNUM LIFE INSURANCE COMPANY | 485 | $311K |
| Long-term disability | FIRST UNUM LIFE INSURANCE COMPANY | 485 | $311K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN, INC. | 69 | $905K |
| Other(4 contracts, 4 carriers) | FIRST UNUM LIFE INSURANCE COMPANY | 579 | $502K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 579 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.