| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 100 SMITH RANCH ROAD, SUITE 112 SAN RAFAEL, CA 94903 | CALIFORNIA PHYSICIANS' SERVICE | $222K | $8K | $230K | 4.08% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 3697 MOUNT DIABLO BOULEVARD SUITE 300 LAFAYETTE, CA 94579 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $63K | — | $63K | 10.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 21ST FLOOR ITASCA, IL 60143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $22K | — | $22K | 8.90% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD SUITE 600 GLENDALE, CA 91203 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | — | $6K | 2.51% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 14TH FLOOR ITASCA, IL 60143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $5K | $5K | 2.21% |
| HODGES-MACE BENEFITS GRP INC3 Filed as: HODGES-MACE BENEFITS GROUP INC. | 5775-D GLENRIDGE DRIVE NE SUITE 350 ATLANTA, GA 30328 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $685 | — | $685 | 0.28% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD GLENDALE, CA 91203 | EYEMED | $7K | — | $7K | 9.52% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 14TH FLOOR ITASCA, IL 60143 | AFLAC | $24 | — | $24 | 4.11% |
| MJ INSURANCE3 Filed as: MARC MIKELSEN AND VARIOUS AGENTS | 1324 SOUTH 1900 E SALT LAKE CITY, UT 84108 | AFLAC | $22 | — | $22 | 3.77% |
| LILY FREGOSO3 | 340 EAST 2ND STREET, SUITE 310 LOS ANGELES, CA 90012 | AFLAC | $21 | — | $21 | 3.60% |
| CRICKET INSURANCE CORPORATION3 | 6573 SOUTH EVENING GLOW COURT WEST VALLEY, UT 84081 | AFLAC | $15 | — | $15 | 2.57% |
| OSCAR FREGOSO3 | 340 EAST 2ND STREET, SUITE 310 LOS ANGELES, CA 90012 | AFLAC | $9 | — | $9 | 1.54% |
| STEVE BELLISTON3 | 3164 SOUTH PARK COURT SALT LAKE CITY, UT 84106 | AFLAC | $7 | — | $7 | 1.20% |
| DAWN A CHRISTENSEN3 Filed as: DAWN CHRISTENSEN | 24516 APPLE STREET NEWHALL, CA 91321 | AFLAC | $6 | — | $6 | 1.03% |
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 | 700 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 219 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 925 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA PHYSICIANS' SERVICE | 1,189 | $5.7M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 527 | $628K |
| Vision | EYEMED | 1,199 | $75K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 700 | $247K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 700 | $247K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 700 | $247K |
| Prescription drug | CALIFORNIA PHYSICIANS' SERVICE | 1,189 | $5.7M |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 700 | $248K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,199 | — |
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.