| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CLEVIDENCE INSURANCE SERVICES INC3 Filed as: CLEVIDENCE INSURANCE SERVICES, INC. | 3000 W MACARTHUR BLVD STE 320 SANTA ANA, CA 92704 | KAISER FOUNDATION HEALTH PLAN INC | $33K | — | $33K | 1.99% |
| CLEVIDENCE INSURANCE SERVICES INC3 Filed as: CLEVIDENCE INSURANCE SERVICES, INC | 3000 W MACARTHUR BLVD STE 320 SANTA ANA, CA 927047907 | KAISER FOUNDATION HEALTH PLAN INC | $10K | — | $10K | 2.24% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SVCS USA INC | 800 N MAGNOLIA AVE STE 110 ORLANDO, FL 32803 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $15K | $15K | 5.06% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SVCS USA INC | PO BOX 201629 DALLAS, TX 75320 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $6K | — | $6K | 2.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SVCS USA INC | 800 N MAGNOLIA AVE, STE 110 ORLANDO, FL 32803 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $14K | $14K | 5.25% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SVCS USA INC | PO BOX 201629 DALLAS, TX 75320 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $5K | — | $5K | 2.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SVCS USA INC | 800 N MAGNOLIA AVE STE 110 ORLANDO, FL 32803 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $13K | $13K | 5.05% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SVCS USA INC | PO BOX 201629 DALLAS, TX 75320 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $5K | — | $5K | 2.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SVCS USA INC | 800 N MAGNOLIA AVE STE 110 STE 15TH FL ORLANDO, FL 32803 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $11K | $11K | 5.14% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SVCS USA INC | PO BOX 201629 DALLAS, TX 753201629 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | — | $4K | 2.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SERVICES USA, INC. | PO BOX 201629 DALLAS, TX 75320 | COMBINED INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 2.02% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SERVICES USA, INC. | 150 N. MICHIGAN AVE., STE 3900 CHICAGO, IL 60601 | COMBINED INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 0.99% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL | PO BOX 201629 DALLAS, TX 753201629 | COMBINED INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 0.97% |
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 | 2,747 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 21 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 55 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,823 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC | 352 | $2.1M |
| Vision | COMBINED INSURANCE COMPANY OF AMERICA | 3,703 | $166K |
| Life insurance(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 2,687 | $500K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 2,235 | $254K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 2,269 | $270K |
| Prescription drug(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC | 352 | $2.1M |
| Other(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 2,687 | $500K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,703 | — |
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."
No prospect flags tripped on this filing.