| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BRIDGESTREET CONSULTING & INSURANCE3 Filed as: BRIDGESTREET CONSULTING & INS. SVCS | 1350 TREAT BLVD #550 WALNUT CREEK, CA 94597 | MINNESOTA LIFE INSURANCE COMPANY | $116K | — | $116K | 6.00% |
| JOSEPH P CALARCO3 Filed as: JOSEPH S. ELLIS JR | UNKNOWN SARASOTA, FL 34240 | HARVARD PILGRIM HEALTH CARE | $32K | — | $32K | 2.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO | 150 N. MICHIGAN AVE. SUITE 3900 CHICAGO, IL 60601 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $34K | — | $34K | 4.59% |
| WELLS FARGO INSURANCE SERVICES3 | 600 HIGHWAY 169 SOUTH, 12TH FLOOR SAINT LOUIS PARK, MN 55426 | KAISER FOUNDATION HEALTH PLAN, INC. | $31K | — | $31K | 4.60% |
| WELLS FARGO INSURANCE SERVICES3 | 3475 PIEDMONT ROAD, SUITE 800 ATLANTA, GA 30305 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $69K | — | $69K | 12.00% |
| VIDAL & RODRIGUEZ3 Filed as: VIDAL & RODRIGUEZ, INC. | CAPITOL CENTER SUITE 501 AVE. ARTERIAL HOSTOS 3 SAN JUAN, PR 00918 | HUMANA INSURANCE COMPANY OF PUERTO RICO, INC. | $2K | — | $2K | 1.20% |
| WELLS FARGO INSURANCE SERVICES3 | 3475 PIEDMONT ROAD, SUITE 800 ATLANTA, GA 30305 | FEDERAL INSURANCE COMPANY | $0 | $1K | $1K | 2.25% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO | 150 N. MICHIGAN AVENUE SUITE 3900 CHICAGO, IL 60601 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $793 | — | $793 | 4.59% |
| WELLS FARGO INSURANCE SERVICES3 | 3475 PIEDMONT ROAD, SUITE 800 ATLANTA, GA 30305 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 12.00% |
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 | 6,573 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 54 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 6,627 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(6 contracts, 6 carriers) | HARVARD PILGRIM HEALTH CARE | 255 | $3.7M |
| Dental(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 46 | $600K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 46 | $576K |
| Life insurance(2 contracts, 2 carriers) | MINNESOTA LIFE INSURANCE COMPANY | 6,065 | $1.9M |
| Short-term disability | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 52 | $17K |
| Long-term disability | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 3,513 | $735K |
| Prescription drug(5 contracts, 5 carriers) | HARVARD PILGRIM HEALTH CARE | 255 | $3.1M |
| Other(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 6,573 | $621K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 6,573 | — |
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.