| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 600 HIGHWAY 169 SOUTH, SUITE 1200 SAINT LOUIS PARK, MN 55426 | AETNA HEALTH, INC. | $44K | — | $44K | 1.95% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 600 HIGHWAY 169 SOUTH, SUITE 1200 SAINT LOUIS PARK, MN 55426 | AETNA LIFE INSURANCE COMPANY | $22K | $9K | $31K | 3.09% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 5901 PRIESTLY DRIVE, SUITE 306 CARLSBAD, CA 92008 | AETNA LIFE INSURANCE COMPANY | — | $80 | $80 | 0.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 15303 VENTURA BOULEVARD, SUITE 700 SHERMAN OAKS, CA 91403 | AETNA LIFE INSURANCE COMPANY | — | $80 | $80 | 0.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 5901 PRIESTLY DRIVE, SUITE 306 CARLSBAD, CA 92008 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $2K | — | $2K | 1.84% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | PO BOX 39000 SAN FRANCISCO, CA 94139 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $6K | — | $6K | 13.60% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 21250 HAWTHORNE BOULEVARD SUITE 600 TORRANCE, CA 90503 | VISION SERVICE PLAN | $2K | — | $2K | 4.22% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 21250 HAWTHORNE BOULEVARD SUITE 600 TORRANCE, CA 90503 | STANDARD INSURANCE COMPANY | $4K | $550 | $5K | 17.09% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | PO BOX 203066 DALLAS, TX 75320 | STANDARD INSURANCE COMPANY | — | $244 | $244 | 0.93% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 5901 PRIESTLY DRIVE, SUITE 306 CARLSBAD, CA 92008 | HAWAII DENTAL SERVICE | $62 | — | $62 | 2.98% |
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 | 357 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 8 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 367 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | AETNA HEALTH, INC. | 552 | $3.4M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF CALIFORNIA | 606 | $164K |
| Vision | VISION SERVICE PLAN | 237 | $37K |
| Life insurance(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 413 | $1.0M |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 43 | $46K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 43 | $46K |
| Prescription drug(3 contracts, 3 carriers) | AETNA HEALTH, INC. | 552 | $3.4M |
| Other(3 contracts, 3 carriers) | AETNA LIFE INSURANCE COMPANY | 413 | $1.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 606 | — |
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.