| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 4100 NEWPORT PLACE DRIVE, SUITE 65 NEWPORT BEACH, CA 92660 | CALIFORNIA PHYSICIANS SERVICE | $28K | — | $28K | 2.99% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS | 18101 VON KARMAN AVENUE, SUITE 600 IRVINE, CA 92612 | CALIFORNIA PHYSICIANS SERVICE | $19K | — | $19K | 2.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ARTHUR J. GALLAGHER & CO. | 4100 NEWPORT PLACE DRIVE, SUITE 650 NEWPORT BEACH, CA 92660 | UNITED CONCORDIA INSURANCE COMPANY | $6K | — | $6K | 7.40% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS | 18101 VON KARMAN AVENUE, SUITE 600 IRVINE, CA 92660 | UNITED CONCORDIA INSURANCE COMPANY | $3K | — | $3K | 3.31% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE | 4100 NEWPORT PLACE DRIVE, SUITE 650 NEWPORT BEACH, CA 92660 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | $444 | $5K | 12.37% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS | 18101 VON KARMAN AVENUE, SUITE 600 IRVINE, CA 92612 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 5.78% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS SERVICES INC | 4100 NEWPORT PLACE DRIVE, SUITE 650 NEWPORT BEACH, CA 92660 | VISION SERVICE PLAN | $1K | — | $1K | 6.74% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS | 18101 VON KARMAN AVENUE, SUITE 600 IRVINE, CA 92612 | VISION SERVICE PLAN | $485 | — | $485 | 3.26% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ARTHUR J. GALLAGHER & CO. | 4100 NEWPORT PLACE DRIVE, SUITE 650 NEWPORT BEACH, CA 92660 | UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. | $563 | — | $563 | 7.62% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS | 18101 VON KARMAN AVENUE, SUITE 600 IRVINE, CA 92612 | UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. | $240 | — | $240 | 3.25% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS SERVICE | 4100 NEWPORT PLACE DRIVE, SUITE 650 NEWPORT BEACH, CA 92660 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $541 | $69 | $610 | 8.54% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS | 18101 VON KARMAN AVENUE, SUITE 600 IRVINE, CA 92612 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $236 | — | $236 | 3.30% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE | 4100 NEWPORT PLACE DRIVE, SUITE 650 NEWPORT BEACH, CA 92660 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $160 | $22 | $182 | 8.61% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS | 18101 VON KARMAN AVENUE, SUITE 600 IRVINE, CA 92612 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $65 | — | $65 | 3.08% |
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 | 149 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 150 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA PHYSICIANS SERVICE | 113 | $933K |
| Dental(2 contracts, 2 carriers) | UNITED CONCORDIA INSURANCE COMPANY | 87 | $86K |
| Vision | VISION SERVICE PLAN | 114 | $15K |
| Life insurance(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 149 | $42K |
| Prescription drug | CALIFORNIA PHYSICIANS SERVICE | 113 | $933K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 149 | $7K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 149 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.