| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE INC. | 160 FEDERAL STREET BOSTON, MA 02110 | BLUE CROSS OF CALIFORNIA | $42K | — | $42K | 3.10% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | TWO PIERCE PLACE ITASCA, IL 60143 | BLUE CROSS OF CALIFORNIA | $20K | — | $20K | 1.46% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSRUANCE BROKERAGE INC. | 2040 MAIN STREET, SUITE 450 IRVINE, CA 92614 | KAISER FOUNDATION HEALTH PLAN INC. | $6K | — | $6K | 3.09% |
| AMWINS3 Filed as: LISI, INC. | 1600 W. HILLSDALE BLVD, SUITE 201 SAN MATEO, CA 94402 | KAISER FOUNDATION HEALTH PLAN INC. | $4K | — | $4K | 2.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS OF CA | 505 N BRAND BLVD, SUITE 600 GLENDALE, CA 91203 | KAISER FOUNDATION HEALTH PLAN INC. | $4K | $1 | $4K | 1.91% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE INC. | 2040 MAIN STREET, SUITE 450 IRVINE, CA 92614 | GUARDIAN | $10K | — | $10K | 5.21% |
| LAWRENCE TODD FUGATE3 Filed as: LAWRENCE M HARTLEY | 2040 MAIN STREET, SUITE 450 IRVINE, CA 92614 | GUARDIAN | — | $7K | $7K | 3.63% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 2850 GOLF ROAD, 5TH FLOOR ROLLING MEADOWS, IL 60008 | GUARDIAN | $6K | — | $6K | 3.50% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 505 N BRAND BLVD, SUITE 600 GLENDALE, CA 91203 | HEALTH PLAN OF NEVADA | $3K | — | $3K | 2.06% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE INC. | 2040 MAIN STREET, SUITE 450 IRVINE, CA 92614 | KAISER FOUNDATION HEALTH PLAN INC. | $1K | — | $1K | 2.30% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS OF CA | 505 N BRAND BLVD, SUITE 600 GLENDALE, CA 91203 | KAISER FOUNDATION HEALTH PLAN INC. | $1K | — | $1K | 2.25% |
| AMWINS3 Filed as: LISI, INC. | 1600 W. HILLSDALE BLVD, SUITE 201 SAN MATEO, CA 94402 | KAISER FOUNDATION HEALTH PLAN INC. | $910 | — | $910 | 1.85% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE INC. | 160 FEDERAL STREET BOSTON, MA 02110 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $419 | — | $419 | 3.09% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | TWO PIERCE PLACE ITASCA, IL 60143 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $198 | — | $198 | 1.46% |
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 | 272 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 281 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 135 | $1.7M |
| Dental | GUARDIAN | 290 | $184K |
| Vision(2 contracts, 2 carriers) | GUARDIAN | 290 | $198K |
| Life insurance(2 contracts, 2 carriers) | GUARDIAN | 290 | $198K |
| Long-term disability | GUARDIAN | 290 | $184K |
| Prescription drug(4 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 135 | $1.7M |
| Other(2 contracts, 2 carriers) | GUARDIAN | 290 | $198K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 290 | — |
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.