| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 4000 MIDLANTIC DRIVE, SUITE 300 MOUNT LAUREL, NJ 08054 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $16K | $16K | 2.15% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $221 | $221 | 0.03% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $40 | $40 | 0.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $8K | $0 | $8K | 20.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 6967 SOUTH RIVER GATE DRIVE SUITE 200 MIDVALE, UT 84047 | METLIFE LEGAL PLANS | $3K | $0 | $3K | 9.18% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD 6TH FLOOR GLENDALE, CA 91203 | METLIFE LEGAL PLANS | $0 | $317 | $317 | 1.16% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 1111 SUPERIOR AVENUE EAST SUITE 1601 CLEVELAND, OH 44114 | METLIFE LEGAL PLANS | $0 | $2 | $2 | 0.01% |
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 | 1,229 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 48 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 43 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,320 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 131 | $361K |
| Dental | DELTA DENTAL OF CALIFORNIA | 2,666 | $1.2M |
| Vision | VISION SERVICE PLAN | 974 | $175K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,137 | $721K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,137 | $721K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 131 | $361K |
| Other(4 contracts, 4 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 3,615 | $852K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,615 | — |
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.