| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS SERVICES, INC. | 500 NORTH SANTA FE VISALIA, CA 93292 | CALIFORNIA PHYSICIANS SERVICE | — | $62K | $62K | 3.92% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 444 W 47TH STREET SUITE 900 KANSAS CITY, MO 64112 | CALIFORNIA PHYSICIANS SERVICE | — | $22K | $22K | 1.40% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 1900 WEST LOOP SOUTH, SUITE 1600 HOUSTON, TX 77027 | METROPOLITAN LIFE INSURANCE COMPANY | $11K | $54 | $11K | 7.75% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES | 23940 DEPT LANE PASADENA, CA 91185 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $71 | $2K | 1.63% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | METROPOLITAN LIFE INSURANCE COMPANY | — | $2K | $2K | 1.19% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES | 444 W 47TH STREET SUITE 900 KANSAS CITY, MO 64112 | METROPOLITAN LIFE INSURANCE COMPANY | — | $278 | $278 | 0.20% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | METROPOLITAN LIFE INSURANCE COMPANY | — | $3 | $3 | 0.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | TWO PIERCE PLACE 21ST FLOOR ITASCA, IL 60143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | — | $7K | 15.00% |
| LIAZON BENEFITS INC3 | 199 SCOTT ST SUITE 800 BUFFALO, NY 14204 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 5.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 2850 W GOLF ROAD 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $569 | $569 | 1.25% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 21ST FLOOR ITASCA, IL 60143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 8.34% |
| LIAZON BENEFITS INC3 Filed as: LIAZON BENEFITS, INC. | 199 SCOTT STREET, SUITE 800 BUFFALO, NY 14204 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 5.00% |
| GALLAGHER BENEFIT SERVICES, INC.2 Filed as: GALLAGHER BENEFIT SERVICES | 2850 W GOLF ROAD 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $322 | $322 | 1.25% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | TWO PIERCE PLACE 21ST FLOOR ITASCA, IL 60143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 15.00% |
| LIAZON BENEFITS INC3 | 199 SCOTT ST SUITE 800 BUFFALO, NY 14204 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $578 | — | $578 | 5.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 2850 W GOLF ROAD 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $144 | $144 | 1.25% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 1900 WEST LOOP SOUTH, SUITE 1600 HOUSTON, TX 77027 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $92 | — | $92 | 8.29% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | — | $16 | $16 | 1.44% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 23940 DEPT LANE PASADENA, CA 91185 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $16 | — | $16 | 1.44% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 444 W 47TH STREET SUITE 900 KANSAS CITY, MO 64112 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | — | $2 | $2 | 0.18% |
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 | 496 | 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) | 496 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA PHYSICIANS SERVICE | 170 | $1.6M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 292 | $142K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 292 | $140K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 496 | $37K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 88 | $46K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 88 | $46K |
| Prescription drug | CALIFORNIA PHYSICIANS SERVICE | 170 | $1.6M |
| Other(3 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 496 | $1.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 496 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.