| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 100 SMITH RANCH ROAD SUITE 112 SAN RAFAEL, CA 94903 | CALIFORNIA PHYSICIANS SERVICE | $78K | $15K | $93K | 3.58% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2056 VISTA PARKWAY SUITE 300 WEST PALM BEACH, FL 33411 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $29K | $0 | $29K | 7.95% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 18201 VON KARMAN AVENUE SUITE 200 IRVINE, CA 92612 | AETNA LIFE INSURANCE COMPANY | $5K | $3K | $8K | 5.24% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 18201 VON KARMAN AVENUE SUITE 200 IRVINE, CA 92612 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $7K | $1K | $9K | 12.05% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD SUITE 1000 ROLLING MEADOWS, IL 60008 | VISION SERVICE PLAN | $2K | $0 | $2K | 5.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE 21ST FLOOR ITASCA, IL 60143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $0 | $4K | 12.49% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $270 | $270 | 0.94% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 21ST FLOOR ITASCA, IL 60143 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 11.47% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 WEST GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $103 | $103 | 0.63% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 18201 VON KARMAN AVENUE SUITE 200 IRVINE, CA 92612 | MAGELLAN HEALTH SERVICES | $662 | $0 | $662 | 10.00% |
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 | 344 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 11 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 355 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA PHYSICIANS SERVICE | 597 | $2.6M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 285 | $369K |
| Vision | VISION SERVICE PLAN | 247 | $31K |
| Life insurance(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 559 | $167K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 556 | $73K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 556 | $73K |
| Prescription drug | CALIFORNIA PHYSICIANS SERVICE | 597 | $2.6M |
| Other(3 contracts, 3 carriers) | AETNA LIFE INSURANCE COMPANY | 559 | $186K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 597 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.