| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 323 WEST LAKESIDE AVENUE, SUITE 410 CLEVELAND, OH 44113 | BLUE CROSS OF CALIFORNIA | $103K | $0 | $103K | 3.71% |
| BEERE & PURVES INC3 Filed as: BEERE AND PURVES, INC. | 500 YGNACIO VALLEY ROAD, SUITE 450 WALNUT CREEK, CA 94596 | BLUE CROSS OF CALIFORNIA | $0 | $4K | $4K | 0.16% |
| ABD INS. AND FINANCIAL SVCS., INC.3 Filed as: ABD INS. AND FINANCIAL SVCS, INC. | 777 MARINERS ISLAND BOULEVARD SUITE 250 SAN MATEO, CA 94404 | BLUE CROSS OF CALIFORNIA | -$524 | — | -$524 | -0.02% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD SUITE 600 GLENDALE, CA 91203 | DELTA DENTAL OF CALIFORNIA | $4K | $0 | $4K | 2.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 333 EAST OSBORN ROAD, SUITE 270 PHOENIX, AZ 85012 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $12K | $3K | $15K | 8.51% |
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 | 122 | 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) | 122 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 112 | $2.8M |
| Dental | DELTA DENTAL OF CALIFORNIA | 276 | $188K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 122 | $180K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 122 | $180K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 122 | $180K |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 112 | $2.8M |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 122 | $180K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 276 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.