| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 11060 WHITE ROCK ROAD, SUITE 160 RANCHO CORDOVA, CA 95670 | KAISER FOUNDATION HEALTH PLAN INC | $28K | $0 | $28K | 4.52% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 14TH FLOOR ITASCA, IL 60143 | KAISER FOUNDATION HEALTH PLAN INC | $0 | $1K | $1K | 0.21% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 11060 WHITE ROCK ROAD, SUITE 160 RANCHO CORDOVA, CA 95670 | WESTERN HEALTH ADVANTAGE | $11K | $0 | $11K | 2.47% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | PRINCIPAL LIFE INSURANCE COMPANY | $11K | $0 | $11K | 10.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 11060 WHITE ROCK ROAD, SUITE 160 RANCHO CORDOVA, CA 95670 | SUTTER HEALTH PLAN | $5K | $0 | $5K | 4.36% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 11060 WHITE ROCK ROAD, SUITE 160 RANCHO CORDOVA, CA 95670 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $7K | $0 | $7K | 11.36% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 11060 WHITE ROCK ROAD, SUITE 160 RANCHO CORDOVA, CA 95670 | GERBER LIFE INSURANCE COMPANY | $1K | $0 | $1K | 8.37% |
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 | 183 | 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) | 183 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 194 | $1.2M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 261 | $115K |
| Vision | GERBER LIFE INSURANCE COMPANY | 99 | $17K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 205 | $63K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 205 | $63K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 205 | $63K |
| Prescription drug(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 194 | $1.2M |
| Other | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 205 | $63K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 261 | — |
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.