| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 10505 SORRENTO VALLEY RD., STE. 200 SAN DIEGO, CA 92121 | OPTIMA HEALTH PLAN | $8K | — | $8K | 3.35% |
| VARIOUS - SEE ATTACHED3 | C/O AFLAC 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $13K | $936 | $14K | 14.10% |
| VARIOUS - SEE ATTACHED3 | C/O CONTINENTAL AMERICAN P.O. BOX 427 COLUMBIA, SC 29202 | CONTINENTAL AMERICAN INSURANCE COMPANY | $8K | — | $8K | 10.70% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 10505 SORRENTO VALLEY RD., STE. 200 SAN DIEGO, CA 92121 | OPTIMA HEALTH PLAN | $2K | — | $2K | 4.58% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENFIT SERVICES INC. | 2850 GOLF ROAD, 5TH FLOOR ROLLING MEADOWS, IL 60008 | BLUE CROSS OF CALIFORNIA | $4K | $278 | $5K | 12.42% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 10505 SORRENTO VALLEY RD., STE. 200 SAN DIEGO, CA 92121 | OPTIMA HEALTH PLAN | $1K | — | $1K | 3.75% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 5TH FLOOR ROLLING MEADOWS, IL 60008 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $3K | $176 | $3K | 12.42% |
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 | 90 | 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) | 90 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts) | OPTIMA HEALTH PLAN | 26 | $316K |
| Dental | BLUE CROSS OF CALIFORNIA | 55 | $37K |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 90 | $23K |
| Life insurance(3 contracts, 3 carriers) | AFLAC | 145 | $200K |
| Short-term disability(2 contracts, 2 carriers) | AFLAC | 145 | $176K |
| Other(3 contracts, 3 carriers) | AFLAC | 145 | $200K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 145 | — |
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.