| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| COMPLIANCE SERVICES AGENCY3 Filed as: S&K COMPLIANCE CHECK LP | 734 SILVER SPUR ROAD# 201 ROLLING HILLS ESTATES, CA 90274 | KAISER FOUNDATION HEALTH PLAN | $25K | $0 | $25K | 3.57% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | KAISER FOUNDATION HEALTH PLAN | $15K | $0 | $15K | 2.09% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60008 | SUN LIFE ASSURANCE COMPANY OF CANADA | $1K | $0 | $1K | 3.82% |
| LIS INSURANCE SOLUTIONS3 | 734 SILVER SPUR ROAD# 201 ROLLING HILLS ESTATES, CA 90274 | SUN LIFE ASSURANCE COMPANY OF CANADA | $409 | $0 | $409 | 1.10% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 2850 GOLF ROAD 5TH FL ROLLING MEADOW, IL 60008 | SUN LIFE ASSURANCE COMPANY OF CANADA | $153 | $0 | $153 | 0.41% |
| COMPLIANCE SERVICES AGENCY3 Filed as: S&K COMPLIANCE CHECK LP | 734 SILVER SPUR ROAD# 201 ROLLING HILLS ESTATES, CA 90274 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $373 | $0 | $373 | 5.60% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $293 | $0 | $293 | 4.40% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: LIS INSURANC SOLUTIONS | 734 SILVER SPUR ROAD# 201 ROLLING HILLS ESTATES, CA 90274 | EYEMED VISION CARE | $330 | $0 | $330 | 7.65% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 505 NORTH BRAND BLVD GLENDALE, CA 91203 | EYEMED VISION CARE | $140 | $0 | $140 | 3.24% |
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 | 143 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 8 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 152 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN | 79 | $704K |
| Dental | SUN LIFE ASSURANCE COMPANY OF CANADA | 38 | $37K |
| Vision | EYEMED VISION CARE | 81 | $4K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 143 | $7K |
| Other | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 143 | $7K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 143 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.