| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 | 13500 EVENING CREEK DRIVE SUITE 450 SAN DIEGO, CA 92128 | CALIFORNIA PHYSICIANS SERVICE | — | $49K | $49K | 3.84% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 444 W 47TH STREET SUITE 900 KANSAS CITY, MO 64112 | CALIFORNIA PHYSICIANS SERVICE | — | $18K | $18K | 1.42% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | PO BOX 632886 CINCINNATI, OH 45263 | METROPOLITAN LIFE INSURANCE COMPANY | $7K | $66 | $7K | 6.50% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES | 23940 DEPT LANE PASADENA, CA 91185 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | $87 | $5K | 4.69% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 444 W 47TH STREET SUITE 900 KANSAS CITY, MO 64112 | METROPOLITAN LIFE INSURANCE COMPANY | — | $836 | $836 | 0.78% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | METROPOLITAN LIFE INSURANCE COMPANY | — | $393 | $393 | 0.37% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | DEPT LA 23940 PASADENA, CA 91185 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $655 | $6K | 8.37% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INSURANCE SERVICE | PO BOX 632886 CINCINNATI, OH 45263 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 7.45% |
| 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 | $678 | — | $678 | 1.02% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 700 WEST 47TH STREET SUITE 1100 KANSAS CITY, MO 64112 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $661 | $661 | 0.99% |
| LIAZON BENEFITS INC3 | 199 SCOTT ST SUITE 800 BUFFALO, NY 14204 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $226 | — | $226 | 0.34% |
| 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 | — | $56 | $56 | 0.08% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | DEPT LA 23940 PASADENA, CA 91185 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $523 | $3K | 4.85% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INSURANCE SERVICE | PO BOX 632886 CINCINNATI, OH 45263 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 3.11% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 700 WEST 47TH STREET SUITE 1100 KANSAS CITY, MO 64112 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $600 | $600 | 1.10% |
| 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 | $164 | — | $164 | 0.30% |
| LIAZON BENEFITS INC3 Filed as: LIAZON BENEFITS, INC. | 199 SCOTT STREET, SUITE 800 BUFFALO, NY 14204 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $117 | — | $117 | 0.22% |
| 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 | — | $29 | $29 | 0.05% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | DEPT LA 23940 PASADENA, CA 91185 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $164 | $1K | 8.52% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INSURANCE SERVICE | PO BOX 632886 CINCINNATI, OH 45263 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 7.31% |
| 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 | $194 | — | $194 | 1.18% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 700 WEST 47TH STREET SUITE 1100 KANSAS CITY, MO 64112 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $160 | $160 | 0.98% |
| LIAZON BENEFITS INC3 | 199 SCOTT ST SUITE 800 BUFFALO, NY 14204 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $65 | — | $65 | 0.40% |
| 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 | — | $16 | $16 | 0.10% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 23940 DEPT LANE PASADENA, CA 91185 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $28 | — | $28 | 6.33% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INSURANCE SERVICE | PO BOX 632886 CINCINNATI, OH 45263 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $28 | — | $28 | 6.33% |
| 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 | — | $5 | $5 | 1.13% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | — | $3 | $3 | 0.68% |
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 | 534 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 535 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA PHYSICIANS SERVICE | 160 | $1.3M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 226 | $108K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 226 | $108K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 540 | $71K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 90 | $67K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 90 | $67K |
| Prescription drug | CALIFORNIA PHYSICIANS SERVICE | 160 | $1.3M |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 540 | $71K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 540 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.