| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | BLUECROSS BLUESHIELD OF TEXAS | $27K | $1K | $28K | 3.22% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 12750 MERIT DRIVE, SUITE 1000 DALLAS, TX 75251 | PRINCIPAL LIFE INSURANCE COMPANY | $8K | $0 | $8K | 9.21% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | PRINCIPAL LIFE INSURANCE COMPANY | $0 | $379 | $379 | 0.44% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | KAISER FOUNDATION HEALTH PLAN INC | $3K | $0 | $3K | 4.96% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INS. SERVICES, INC. | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 91361 | KAISER FOUNDATION HEALTH PLAN INC | $2K | $0 | $2K | 2.43% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 12750 MERIT DRIVE, SUITE 1000 DALLAS, TX 75251 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | $0 | $3K | 10.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $960 | $960 | 2.96% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 12750 MERIT DRIVE, SUITE 1000 DALLAS, TX 75251 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIEF INSURANCE CO. | $717 | $0 | $717 | 10.86% |
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 | 100 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 100 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUECROSS BLUESHIELD OF TEXAS | 146 | $949K |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 158 | $85K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIEF INSURANCE CO. | 100 | $7K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 109 | $32K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 109 | $32K |
| Prescription drug(2 contracts, 2 carriers) | BLUECROSS BLUESHIELD OF TEXAS | 146 | $949K |
| Other | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 109 | $32K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 158 | — |
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."
No prospect flags tripped on this filing.