| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 4100 NEWPORT PLACE DR. NEWPORT BEACH, CA 92660 | CALIFORNIA PHYSICIANS SERVICE | $47K | — | $47K | 4.14% |
| NIELSEN INSURANCE GROUP INC3 Filed as: NIELSEN INSURANCE GROUP INC. | 4165 E THOUSAND OAKS BLVD THOUSAND OAKS, CA 91362 | CALIFORNIA PHYSICIANS SERVICE | $10K | — | $10K | 0.86% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 4100 NEWPORT PLANCE DR. STE 650 NEWPORT BEACH, CA 92660 | METROPOLITAN LIFE INSURANCE COMPANY | $9K | $64 | $9K | 9.04% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | P.O. BOX 3009 ARLINGTON HEIGHTS, IL 60006 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $1K | $1K | 1.34% |
| NIELSEN INSURANCE GROUP INC3 Filed as: NIELSEN INSURANCE GROUP INC. | P.O. BOX 6549 WESTLAKE VILLAGE, CA 91359 | METROPOLITAN LIFE INSURANCE COMPANY | $941 | — | $941 | 0.91% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SERVICES OF | CALIFORNIA INC. P.O. BOX 101162 PASADENA, CA 91189 | METROPOLITAN LIFE INSURANCE COMPANY | — | $129 | $129 | 0.12% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SERVICES OF | CALIFORNIA INC. P.O. BOX 101162 PASADENA, CA 91189 | METROPOLITAN LIFE INSURANCE COMPANY | — | $95 | $95 | 0.09% |
| GALLAGHER BENEFIT SERVICES, INC.3 | P.O. BOX 3009 ARLINGTON HEIGHTS, IL 60006 | RELIASTAR LIFE INSURANCE COMPANY | $6K | — | $6K | 9.99% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAHER BENEFIT SERVICES, INC. | P.O. BOX 3009 ARLINGTON HEIGHTS, IL 60006 | RELIASTAR LIFE INSURANCE COMPANY | $1K | — | $1K | 2.25% |
| NIELSEN INSURANCE GROUP INC3 Filed as: NIELSEN INSURANCE GROUP, INC. | 4165 E THOUSAND OAKS BLVD WESTLAKE VLG, CA 91362 | RELIASTAR LIFE INSURANCE COMPANY | $1K | — | $1K | 1.99% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 4100 NEWPORT PLACE DR. STE 650 NEWPORT BEACH, CA 92660 | VISION SERVICE PLAN | $2K | — | $2K | 8.33% |
| NIELSEN INSURANCE GROUP INC3 Filed as: NIELSEN INSURANCE GROUP, INC. | 4165 E T.O. BLVD STE 325 WESTLAKE VILLAGE, CA 93162 | VISION SERVICE PLAN | $304 | — | $304 | 1.67% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 4100 NEWPORT PLACE DR STE 650 NEWPORT BEACH, CA 92660 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $740 | — | $740 | 9.11% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | P.O. BOX 3009 ARLINGTON HEIGHTS, IL 60006 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | — | $109 | $109 | 1.34% |
| NIELSEN INSURANCE GROUP INC3 Filed as: NIELSEN INSURANCE GROUP INC. | P.O. BOX 6549 WESTLAKE VILLAGE, CA 91359 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $80 | — | $80 | 0.98% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SERVICES OF | CALIFORNIA INC. P.O. BOX 101162 PASADENA, CA 91189 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | — | $15 | $15 | 0.18% |
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 | 195 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 195 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA PHYSICIANS SERVICE | 195 | $1.1M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 260 | $112K |
| Vision | VISION SERVICE PLAN | 144 | $18K |
| Life insurance | RELIASTAR LIFE INSURANCE COMPANY | 168 | $63K |
| Long-term disability | RELIASTAR LIFE INSURANCE COMPANY | 168 | $63K |
| Prescription drug | CALIFORNIA PHYSICIANS SERVICE | 195 | $1.1M |
| Other | RELIASTAR LIFE INSURANCE COMPANY | 168 | $63K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 260 | — |
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.