| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | AETNA LIFE INSURANCE COMPANY | $0 | $108K | $108K | 3.51% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 6967 SOUTH RIVER GATE DRIVE SUITE 200 SALT LAKE CITY, UT 84047 | DELTA DENTAL OF CALIFORNIA | $8K | $0 | $8K | 5.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | HARTFORD LIFE AND ACCIDENT | $13K | $0 | $13K | 9.58% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 111 VETERANS BOULEVARD, SUITE 1130 METAIRIE, LA 70005 | CONTINENTAL AMERICAN INSURANCE COMPANY | $13K | $0 | $13K | 60.88% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 6340 SOUTH 3000 EAST, SUITE 500 SALT LAKE CITY, UT 84121 | VISION SERVICE PLAN | $1K | — | $1K | 5.00% |
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 | 175 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 175 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE COMPANY | 397 | $3.1M |
| Dental | DELTA DENTAL OF CALIFORNIA | 377 | $165K |
| Vision | VISION SERVICE PLAN | 376 | $21K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 175 | $132K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 175 | $132K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 175 | $132K |
| Prescription drug | AETNA LIFE INSURANCE COMPANY | 397 | $3.1M |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 175 | $154K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 397 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.