| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 245 SOUTH EXECUTIVE DRIVE SUITE 200 BROOKFIELD, WI 53005 | HUMANA INSURANCE COMPANY | $16K | $0 | $16K | 2.79% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 70 NE LOOP 410, SUITE 325 SUITE 200 SAN ANTONIO, TX 78216 | HUMANA INSURANCE COMPANY | $3K | $0 | $3K | 0.56% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 245 SOUTH EXECUTIVE DRIVE SUITE 200 BROOKFIELD, WI 53005 | HUMANA WISCONSIN HEALTH ORGANIZATION INSURANCE CORPORATION | $9K | $0 | $9K | 2.71% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 70 NE LOOP 410, SUITE 325 SUITE 200 SAN ANTONIO, TX 78216 | HUMANA WISCONSIN HEALTH ORGANIZATION INSURANCE CORPORATION | $1K | $0 | $1K | 0.29% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 245 SOUTH EXECUTIVE DRIVE SUITE 200 BROOKFIELD, WI 53005 | KAISER FOUNDATION HEALTH PLAN INC | $14K | $0 | $14K | 7.43% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 245 SOUTH EXECUTIVE DRIVE SUITE 200 BROOKFIELD, WI 53005 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $6K | $0 | $6K | 15.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 245 SOUTH EXECUTIVE DRIVE SUITE 200 BROOKFIELD, WI 53005 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $0 | $3K | 15.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 245 SOUTH EXECUTIVE DRIVE SUITE 200 BROOKFIELD, WI 53005 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $0 | $2K | 15.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | NORTH 27, WEST 23960 PAUL ROAD PEWAUKEE, WI 53072 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $342 | $2 | $344 | 5.80% |
| CONCIERGE BENEFITS & INSURANCE SERV3 Filed as: CONCIERGE BENEFITS AND INS. SVCS. | 925 NORTH VULCAN AVENUE ENCINITAS, CA 92024 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $198 | $5 | $203 | 3.42% |
| JOSEPH RUBINO3 | 2490 GROSSMONT COLLEGE DRIVE EL CAJON, CA 92020 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $176 | $3 | $179 | 3.02% |
| MJ INSURANCE3 Filed as: JENNIFER M. NILA AND VARIOUS AGENTS | PO BOX 27704 SAN DIEGO, CA 92198 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $115 | $46 | $161 | 2.71% |
| WILLIAM ERNEST DOBSON3 | PO BOX 27207 SAN DIEGO, CA 92198 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $126 | $0 | $126 | 2.12% |
| ANDREA MARIE TIERCE3 | 2204 PLEASANTWOOD LANE ESCONDIDO, CA 92026 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $84 | $33 | $117 | 1.97% |
| MICHAEL C WALKER3 Filed as: MICHAEL J. MINNEY | PO BOX 365 POWAY, CA 92074 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $26 | $1 | $27 | 0.46% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $54 | $54 | 1.37% |
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 | 169 | 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) | 169 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 5 carriers) | HUMANA INSURANCE COMPANY | 115 | $1.2M |
| Dental(2 contracts, 2 carriers) | HUMANA INSURANCE COMPANY | 115 | $561K |
| Vision | HUMANA INSURANCE COMPANY | 115 | $557K |
| Life insurance(3 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 169 | $58K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 17 | $20K |
| Long-term disability(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 169 | $52K |
| Prescription drug(3 contracts, 3 carriers) | HUMANA INSURANCE COMPANY | 115 | $1.1M |
| Other(3 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 169 | $58K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 169 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.