| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 1039-A NORTH MCDOWELL BOULEVARD PETALUMA, CA 94954 | BLUE CROSS OF CALIFORNIA | $120K | — | $120K | 5.02% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 1039-A NORTH MCDOWELL BOULEVARD PETALUMA, CA 94954 | KAISER FOUNDATION HEALTH PLAN INC | $51K | — | $51K | 2.39% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 1018 WEST 9TH AVENUE KING OF PRUSSIA, PA 19406 | METROPOLITAN LIFE INSURANCE COMPANY | — | $9K | $9K | 1.64% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 600 HIGHWAY 169 SOUTH, 18TH FLOOR SAINT LOUIS PARK, MN 55426 | METROPOLITAN LIFE INSURANCE COMPANY | $8K | $27 | $8K | 1.51% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 959 SKYWAY ROAD, 2ND FLOOR SAN CARLOS, CA 94070 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $26K | — | $26K | 10.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | PO BOX 30001 TAMPA, FL 33601 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $8K | $8K | 3.05% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 1039-A NORTH MCDOWELL BOULEVARD PETALUMA, CA 94954 | VISION SERVICE PLAN | $2K | — | $2K | 2.71% |
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 | 669 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 29 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 701 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 413 | $4.5M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 811 | $518K |
| Vision | VISION SERVICE PLAN | 521 | $91K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 682 | $263K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 682 | $263K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 682 | $263K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 413 | $4.5M |
| Other | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 682 | $263K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 811 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.