| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | PO BOX 201503 DALLAS, TX 75320 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $92K | $40K | $132K | 14.42% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | 600 HIGHWAY 169 SOUTH FLOOR 12 ST LOUIS PARK, MN 55426 | KAISER FOUNDATION HEALTH PLAN INC. | $12K | $0 | $12K | 2.77% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | 600 HIGHWAY 169 SOUTH FLOOR 12 ST LOUIS PARK, MN 55426 | KAISER FOUNDATION HEALTH PLAN INC. | $7K | $0 | $7K | 3.17% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO SERVICES | PO BOX 201503 DALLAS, TX 75320 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $22K | $4K | $26K | 15.27% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | UNKNOWN ATLANTA, GA 30328 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $0 | $3K | 1.49% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | PO BOX 201503 DALLAS, TX 75320 | EYEMED VISION CARE | $12K | $0 | $12K | 9.08% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 600 HIGHWAY 169 SOUTH SUITE 1200 ST LOUIS, MN 55426 | EYEMED VISION CARE | $3K | $0 | $3K | 1.89% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | UNKNOWN ATLANTA, GA 30328 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $3K | $0 | $3K | 11.14% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | PO BOX 201503 GEORGIA LOCKBOX DALLAS, TX 75320 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $303 | $0 | $303 | 9.99% |
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 | 1,832 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 36 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,870 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 81 | $690K |
| Vision | EYEMED VISION CARE | 1,877 | $137K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,832 | $916K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,832 | $916K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1 | $168K |
| Prescription drug(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC. | 81 | $667K |
| Other(3 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,915 | $1.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,915 | — |
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.