| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | KAISER FOUNDATION HEALTH PLAN INC | $195K | $0 | $195K | 3.15% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 738 NORTH 1ST STREET, SUITE 202 SAN JOSE, CA 95112 | KAISER FOUNDATION HEALTH PLAN INC | $0 | $3K | $3K | 0.05% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 1076 HIGHLAND COLONY PARKWAY SUITE 300 RIDGELAND, MS 39157 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $22K | $942 | $23K | 14.49% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | VISION SERVICE PLAN | $2K | $0 | $2K | 2.10% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 1900 WEST LOOP SOUTH, SUITE 1600 HOUSTON, TX 77027 | VISION SERVICE PLAN | $622 | $0 | $622 | 0.79% |
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 | 779 | 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) | 779 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 966 | $6.2M |
| Vision | VISION SERVICE PLAN | 732 | $79K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 779 | $158K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 779 | $158K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 966 | $6.2M |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 779 | $158K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 966 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.