| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 1255 BATTERY STREET, SUITE 450 SAN FRANCISCO, CA 94111 | COMMUNITY CARE HEALTH | $60K | $0 | $60K | 5.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 500 NORTH SANTA FE STREET VISALIA, CA 93292 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $0 | $3K | 10.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 736 SOUTH STONE AVENUE LA GRANGE, IL 60525 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $585 | $585 | 2.22% |
| ALLIANT INSURANCE SERVICES, INC.3 | 701 B STREET, 6TH FLOOR SAN DIEGO, CA 92101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $385 | $385 | 1.46% |
| ALLIANT INSURANCE SERVICES, INC.3 | 575 MARKET STREET, SUITE 3600 SAN FRANCISCO, CA 94105 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $0 | $4K | 19.61% |
| ALLIANT INSURANCE SERVICES, INC.3 | 18100 VON KARMAN AVENUE, 10TH FLOOR IRVINE, CA 92612 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $267 | $267 | 1.24% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 800 EDGEWOOD PLACE WINDSOR, CA 95492 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $244 | $0 | $244 | 1.14% |
| RELATION INSURANCE SERVICES OF CA3 Filed as: RELATION INSURANCE SERVICES | 1277 TREAT BOULEVARD, SUITE 400 WALNUT CREEK, CA 94597 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6 | $0 | $6 | 0.03% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $1 | $1 | 0.00% |
| ALLIANT INSURANCE SERVICES, INC.3 | 575 MARKET STREET, SUITE 3600 SAN FRANCISCO, CA 94105 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $0 | $4K | 22.05% |
| ALLIANT INSURANCE SERVICES, INC.3 | 18100 VON KARMAN AVENUE, 10TH FLOOR IRVINE, CA 92612 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $309 | $309 | 1.92% |
| RELATION INSURANCE SERVICES OF CA3 Filed as: RELATION INSURANCE SERVICES | 1277 TREAT BOULEVARD, SUITE 400 WALNUT CREEK, CA 94597 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $147 | $0 | $147 | 0.91% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 800 EDGEWOOD PLACE WINDSOR, CA 95492 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $80 | $0 | $80 | 0.50% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $13 | $13 | 0.08% |
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 | 209 | 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) | 209 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COMMUNITY CARE HEALTH | 340 | $1.2M |
| Dental | COMMUNITY CARE HEALTH | 340 | $1.2M |
| Vision | COMMUNITY CARE HEALTH | 340 | $1.2M |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 207 | $26K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 44 | $16K |
| Prescription drug | COMMUNITY CARE HEALTH | 340 | $1.2M |
| Other(3 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 210 | $52K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 340 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
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.