| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 500 N BRAND BLVD STE 100 GLENDALE, CA 91203 | KAISER FOUNDATION HEALTH PLAN INC | $77K | $0 | $77K | 3.20% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 505 NORTH BRAND BOULEVARD SUITE 600 GLENDALE, CA 91203 | CALIFORNIA PHYSICIANS' SERVICE | $4K | $36K | $40K | 2.75% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 505 NORTH BRAND BLVD FL 6 GLENDALE, CA 91203 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $20K | $0 | $20K | 10.00% |
| FMLASOURCE INC5 | 455 N CITYFRONT PLAZA DRIVE 13TH FLOOR CHICAGO, IL 60611 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $16K | $16K | 7.86% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | NATIONAL INCENTIVE 736 S STONE AVE LA GRANGE, IL 60525 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $8K | $8K | 3.94% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | METROPOLITAN LIFE INSURANCE COMPANY | $11K | $107 | $11K | 10.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 95287 CHICAGO, IL 60694 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $2K | $2K | 1.45% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $6K | $0 | $6K | 9.95% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 95287 CHICAGO, IL 60690 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $0 | $881 | $881 | 1.48% |
| GALLAGHER BENEFIT SERVICES, INC.4 Filed as: GALLAGHER BENEFIT SERVICES INC. | 2850 GOLF RD STE 1000 ROLLING MEADOWS, IA 60008 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $439 | $0 | $439 | 5.99% |
| SUCCESS STRATEGIES, INC.4 Filed as: SUCCESS STRATEGIES INC | 338 FARM RD 71 E SULPHUR SPRINGS, TX 75482 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $73 | $0 | $73 | 1.00% |
| DORSEY & ASSOCIATES, INC.4 Filed as: DORSEY & ASSOCIATES | 1655 VINERY AVE CUMMING, GA 30041 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $73 | $0 | $73 | 1.00% |
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 | 441 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 45 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 489 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 275 | $3.9M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 422 | $167K |
| Vision | CALIFORNIA PHYSICIANS' SERVICE | 171 | $1.5M |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 442 | $198K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 442 | $198K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 442 | $198K |
| Prescription drug | CALIFORNIA PHYSICIANS' SERVICE | 171 | $1.5M |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 442 | $205K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 442 | — |
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.