| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LUMITY, INC.3 Filed as: LUMITY INSURANCE SERVICES, INC. | 28 EAST 3RD AVENUE SAN MATEO, CA 94401 | AETNA LIFE INSURANCE COMPANY | $95K | $0 | $95K | 2.44% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 4000 MIDLANTIC AVENUE MT LAUREL, NJ 08054 | AETNA LIFE INSURANCE COMPANY | $65K | $0 | $65K | 1.67% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | AETNA LIFE INSURANCE COMPANY | $32K | $0 | $32K | 0.82% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 8800 EAST RAINTREE DRIVE, SUITE 250 SCOTTSDALE, AZ 85260 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $46K | $10K | $56K | 8.31% |
| LUMITY, INC.3 | 5214F DIAMOND HEIGHTS BOULEVARD SAN FRANCISCO, CA 94131 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $19K | $5K | $24K | 3.56% |
| LUMITY, INC.3 Filed as: LUMITY INSURANCE SERVICES, INC. | 28 EAST 3RD AVENUE SAN MATEO, CA 94401 | AETNA HEALTH OF CALIFORNIA, INC. | $5K | $0 | $5K | 2.33% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 4000 MIDLANTIC AVENUE MT LAUREL, NJ 08054 | AETNA HEALTH OF CALIFORNIA, INC. | $4K | $0 | $4K | 1.76% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | AETNA HEALTH OF CALIFORNIA, INC. | $2K | $0 | $2K | 0.91% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 500 NORTH BRAND BOULEVARD SUITE 100 GLENDALE, CA 91203 | KAISER FOUNDATION HEALTH PLAN, INC. | $5K | $0 | $5K | 3.83% |
| LUMITY, INC.3 | 5214F DIAMOND HEIGHTS BOULEVARD SAN FRANCISCO, CA 94131 | KAISER FOUNDATION HEALTH PLAN, INC. | $1K | $0 | $1K | 1.16% |
| LUMITY, INC.3 | 71 EAST 3RD AVENUE SAN MATEO, CA 94401 | KAISER FOUNDATION HEALTH PLAN OF COLORADO | $539 | $0 | $539 | 2.95% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 5TH FLOOR ROLLING MEADOWS, IL 60008 | KAISER FOUNDATION HEALTH PLAN OF COLORADO | $446 | $0 | $446 | 2.44% |
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 | 323 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 330 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | AETNA LIFE INSURANCE COMPANY | 585 | $4.2M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 330 | $671K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 330 | $671K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 330 | $671K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 330 | $671K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 330 | $671K |
| Prescription drug(4 contracts, 4 carriers) | AETNA LIFE INSURANCE COMPANY | 585 | $4.2M |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 330 | $671K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 585 | — |
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.