| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 160 WEST SANTA CLARA STREET SAN JOSE, CA 95113 | CALIFORNIA PHYSICIANS SERVICE | $29K | $0 | $29K | 5.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 11060 WHITE ROCK ROAD, SUITE 160 RANCHO CORDOVA, CA 95670 | KAISER FOUNDATION HEALTH PLAN INC | $8K | $887 | $9K | 5.64% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | KAISER FOUNDATION HEALTH PLAN INC | $0 | $156 | $156 | 0.10% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | METROPOLITAN LIFE INSURANCE COMPANY | $12K | $2K | $13K | 10.94% |
| LIAZON BENEFITS INC5 Filed as: LIAZON BENEFITS, INC. | 199 SCOTT STREET, 8TH FLOOR BUFFALO, NY 14204 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $6K | $6K | 4.82% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLNGTON HEIGHTS, IL 60006 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | $0 | $2K | 29.83% |
| LIAZON BENEFITS INC3 Filed as: LIAZON BENEFITS, INC. | 199 SCOTT STREET, 8TH FLOOR BUFFALO, NY 14204 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | $0 | $1K | 19.81% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60014 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $465 | $65 | $530 | 11.21% |
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 | 135 | 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) | 135 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 159 | $748K |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 143 | $126K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 143 | $121K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 143 | $121K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 143 | $121K |
| Prescription drug | CALIFORNIA PHYSICIANS SERVICE | 159 | $584K |
| Other(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 143 | $129K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 159 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.