| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | UNKNOWN DALLAS, TX 75208 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $54K | $0 | $54K | 4.75% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | PO BOX 203510 DALLAS, TX 75320 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $126K | $13K | $138K | 19.88% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 600 HIGHWAY 169 SOUTH, SUITE 12 SAINT LOUIS PARK, MN 554261205 | KAISER FOUNDATION HEALTH PLAN INC | $10K | $0 | $10K | 5.29% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | UNKNOWN WINSTON-SALEM, NC 27101 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $12K | $0 | $12K | 6.60% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | UNKNOWN WINSTON-SALEM, NC 27101 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $6K | $0 | $6K | 3.29% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 203491 DALLAS, TX 75320 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $12K | $0 | $12K | 33.62% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 6100 FAIRVIEW ROAD 8TH FLOOR CHARLOTTE, NC 28210 | LEGALPLANS, USA | $0 | $2K | $2K | 10.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | PO BOX 203491 DALLAS, TX 75320 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | $0 | $2K | 14.90% |
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 | 1,234 | 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) | 1,234 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 31 | $185K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 2,899 | $1.1M |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 2,629 | $176K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,234 | $696K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,234 | $696K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 31 | $185K |
| Other(5 contracts, 4 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,234 | $762K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,899 | — |
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.