| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DAVID CRITZER3 | 19925 STEVENS CREEK BLVD CUPERTINO, CA 950142300 | KAISER FOUNDATION HEALTH PLAN INC | $26K | — | $26K | 5.93% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE | 2 PIERCE PL 14TH FLOOR ITASCA, IL 60143 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $13K | — | $13K | 4.92% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE | 2 PIERCE PL 14TH FL ITASCA, IL 60143 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $12K | — | $12K | 5.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES - | ST. LOUIS 12444 POWERSCOURT DR STE 500 SAINT LOUIS, MO 631313623 | VISION SERVICE PLAN | $8K | — | $8K | 5.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE | 2 PIERCE PL ITASCA, IL 60143 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | — | $6K | 5.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE | 2 PIERCE PL 14TH FL ITASCA, IL 60143 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 5.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 210 INDUSTRIAL PARK ROAD SUITE 130 JOHNSTON, PA 15904 | NATIONAL UNION FIRE INS. CO. OF PITTSBURGH, PA | $4K | — | $4K | 25.00% |
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 | 1,801 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,810 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 102 | $444K |
| Vision | VISION SERVICE PLAN | 1,025 | $151K |
| Life insurance(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,787 | $397K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,769 | $237K |
| Other(5 contracts, 5 carriers) | PREFERRED RESOURCE NETWORK INC D/B/A PERSONAL ASSISTANCE SERVICES | 1,981 | $81K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,981 | — |
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.