| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 323 WEST LAKESIDE AVENUE STE 410 CLEVELAND, OH 44113 | BLUE CROSS OF CALIFORNIA | $115K | $2K | $117K | 4.17% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $9K | $0 | $9K | 6.95% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ARTHUR J GALLAGHER INSURANCE BROKER | 505 N BRAND BLVD 600 GLENDALE, CA 91203 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $7K | $0 | $7K | 15.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ARTHUR J GALLAGHER INSURANCE BROKER | 505 N BRAND BLVD FL 6 GLENDALE, CA 91203 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $0 | $2K | 7.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ARTHUR J GALLAGHER INSURANCE BROKER | 505 N BRAND BLVD STE 600 GLENDALE, CA 91203 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $878 | $0 | $878 | 7.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ARTHUR J GALLAGHER INSURANCE BROKER | 505 N BRAND BLVD 600 GLENDALE, CA 91203 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $0 | $2K | 15.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ARTHUR J GALLAGHER INSURANCE BROKER | 505 N BRAND BLVD FL 6 GLENDALE, CA 91203 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $901 | $0 | $901 | 14.99% |
| GALLAGHER BENEFIT SERVICES, INC.4 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF ROAD STE 1000 ROLLING MEADOWS, IL 60008 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $392 | $0 | $392 | 8.19% |
| CHRISTA G AUFDEMBERG INC4 | 13102 BRITTANY WOODS DRIVE TUSTIN, CA 92780 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $191 | $0 | $191 | 3.99% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ARTHUR J GALLAGHER INSURANCE BROKER | 505 N BRAND BLVD 600 GLENDALE, CA 91203 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $455 | $0 | $455 | 10.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 505 N. BRAND BLVD STE 600 GLENDALE, CA 91203 | UNITEDHEALTHCARE INSURANCE COMPANY | $107 | $0 | $107 | 4.00% |
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 | 155 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 156 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 248 | $2.9M |
| Dental(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 120 | $212K |
| Vision(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 248 | $2.9M |
| Life insurance(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 153 | $34K |
| Short-term disability(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 49 | $17K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 153 | $45K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 248 | $2.9M |
| Other(4 contracts, 3 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 153 | $25K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 248 | — |
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.