| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF RD 5TH FLOOR ROLLING MEADOWS, CA 60008 | BLUE CROSS OF CALIFORNIA | $13K | $0 | $13K | 3.28% |
| RANKIN, BRENDA3 | 12429 OLIVE PLACE CHINO, CA 91710 | BLUE CROSS OF CALIFORNIA | $7K | $0 | $7K | 1.75% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN INSURANCE | 721 S PARKER STREET ORANGE, CA 92868 | BLUE CROSS OF CALIFORNIA | $2K | $0 | $2K | 0.38% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE | — | DELTA DENTAL OF CALIFORNIA | $5K | $0 | $5K | 10.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE | — | DELTA DENTAL OF CALIFORNIA | $1K | $0 | $1K | 10.00% |
| BRENDA RANKIN3 | 12429 OLIVE PL CHINO, CA 91710 | STANDARD INSURANCE COMPANY | $742 | $0 | $742 | 8.04% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 505 NORTH BRAND BLVD STE 600 GLENDALE, CA 91203 | STANDARD INSURANCE COMPANY | $487 | $0 | $487 | 5.28% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 505 N BRAND BLVD FL 6 GLENDALE, CA 91203 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $431 | $0 | $431 | 15.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF RD ROLLING MEADOWS, IL 60008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $103 | $103 | 3.58% |
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 | 104 | 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) | 104 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 82 | $401K |
| Dental(2 contracts) | DELTA DENTAL OF CALIFORNIA | 65 | $68K |
| Life insurance(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 102 | $12K |
| Long-term disability | STANDARD INSURANCE COMPANY | 0 | $9K |
| Other(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 102 | $12K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 102 | — |
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.