| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 3697 MOUNT DIABLO BOULEVARD SUITE 300 LAFAYETTE, CA 94549 | UNITED HEALTHCARE INSURANCE COMPANY | — | $68K | $68K | 3.09% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 14TH FLOOR ITASCA, IL 60143 | METROPOLITAN LIFE INSURANCE COMPANY | — | $56 | $56 | 0.04% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 906 WEST 2ND AVENUE, SUITE 400 SPOKANE, WA 99201 | METROPOLITAN LIFE INSURANCE COMPANY | — | $41 | $41 | 0.03% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 3697 MOUNT DIABLO BOULEVARD SUITE 300 LAFAYETTE, CA 94549 | SYMETRA LIFE INSURANCE COMPANY | $9K | — | $9K | 7.91% |
| REUBEN WARNER ASSOCIATES, INC.3 | 1655 RICHMOND AVENUE STATEN ISLAND, NY 10314 | FEDERAL INSURANCE COMPANY | $349 | — | $349 | 19.99% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 1255 BATTERY STREET SAN FRANCISCO, CA 94111 | FEDERAL INSURANCE COMPANY | $262 | — | $262 | 15.01% |
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 | 171 | 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) | 171 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITED HEALTHCARE INSURANCE COMPANY | 347 | $2.2M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 362 | $127K |
| Vision | VISION SERVICE PLAN | 1,167 | $183K |
| Life insurance | SYMETRA LIFE INSURANCE COMPANY | 171 | $116K |
| Short-term disability | SYMETRA LIFE INSURANCE COMPANY | 171 | $116K |
| Long-term disability | SYMETRA LIFE INSURANCE COMPANY | 171 | $116K |
| Prescription drug | UNITED HEALTHCARE INSURANCE COMPANY | 347 | $2.2M |
| Other(3 contracts, 3 carriers) | SYMETRA LIFE INSURANCE COMPANY | 171 | $121K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,167 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.