| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GCG FINANCIAL LLC3 Filed as: GCG FINANCIAL INC | SUITE 200 SOUTH 3000 LAKESHORE DRIVE BANNOCKBURN, IL 60015 | PRUDENTIAL | $344K | — | $344K | 10.29% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE CHICAGO, IL 60603 | PRUDENTIAL | — | $5K | $5K | 0.14% |
| HARVARD PRINTING GROUP5 | 175 US HIGHWAY 46 WEST FARIFIELD, NJ 07004 | PRUDENTIAL | — | $1K | $1K | 0.04% |
| GBA OF CALIFORNIA/IEBS INC.3 Filed as: GBA OF CALIFORNIA / IEBS INC. | 400 OYSTER POINT BLVD SUITE 110 SOUTH SAN FRANCISCO, CA 94080 | AXIS INSURANCE COMPANY | $6K | — | $6K | 15.00% |
| ANTHEM INSURANCE COMPANIES, INC. | 3360 PEACHTREE ATLANTA, GA 30326 | ANTHEM INSURANCE COMPANIES, INC. | $5.2M | $128K | $5.3M | — |
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 | 10,221 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 122 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 10,343 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN CALIFORNIA, INC. | 246 | $1.2M |
| Dental(3 contracts, 3 carriers) | DELAWARE AMERICAN LIFE INSURANCE CO | 7,825 | $27K |
| Vision | VISION SERVICE PLAN | 8,458 | $1.2M |
| Life insurance(2 contracts) | PRUDENTIAL | 21,206 | $5.0M |
| Short-term disability | PRUDENTIAL | 21,206 | $1.7M |
| Long-term disability(2 contracts) | PRUDENTIAL | 21,206 | $5.0M |
| Prescription drug(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN CALIFORNIA, INC. | 246 | $1.2M |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | AMERICAN ALTERNATIVE INSURANCE CORP | 10,221 | $795K |
| Other(2 contracts, 2 carriers) | PRUDENTIAL | 1,592 | $245K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 21,206 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.