| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 150 NORTH MICHIGAN AVENUE SUITE 3900 CHICAGO, IL 60601 | KAISER FOUNDATION HEALTH PLAN INC | $51K | — | $51K | 3.29% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | PO BOX 39000 SAN FRANCISCO, CA 94139 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $14K | — | $14K | 3.83% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 959 SKYWAY ROAD, SUITE 200 SAN CARLOS, CA 94070 | VISION SERVICE PLAN | $2K | — | $2K | 2.85% |
| INSURANCE TO GO3 | 500 PROFESSIONAL CENTER DRIVE SUITE 515 NOVATO, CA 94947 | FOUR EVER LIFE INSURANCE COMPANY | $7K | — | $7K | 12.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 45 FREMONT STREET, SUITE 800 SAN FRANCISCO, CA 94105 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $311 | $9 | $320 | 5.18% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 49 FREMONT STREET, SUITE 800 SAN FRANCISCO, CA 94105 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $120 | $25 | $145 | 4.13% |
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 | 505 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 511 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 505 | $1.6M |
| Dental | DELTA DENTAL OF CALIFORNIA | 1,117 | $494K |
| Vision | VISION SERVICE PLAN | 555 | $81K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 505 | $359K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 505 | $359K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 505 | $359K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 237 | $1.6M |
| Other(4 contracts, 4 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 607 | $400K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,117 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.