| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 4100 NEWPORT PLACE DRIVE, SUITE 650 NEWPORT BEACH, CA 92660 | CALIFORNIA PHYSICIANS' SERVICE | $41K | $5K | $46K | 4.83% |
| WARREN G BENDER CO3 | 516 GIBSON DRIVE, SUITE 240 ROSEVILLE, CA 95678 | CALIFORNIA PHYSICIANS' SERVICE | $6K | — | $6K | 0.66% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 11060 WHITE ROCK ROAD #160 RANCHO CORDOVA, CA 95670 | HUMANADENTAL INSURANCE COMPANY | $2K | — | $2K | 3.86% |
| WARREN G BENDER CO3 | 516 GIBSON DR STE 240 ROSEVILLE, CA 95678 | HUMANADENTAL INSURANCE COMPANY | $731 | — | $731 | 1.56% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 4100 NEWPORT PLACE DRIVE, SUITE 650 NEWPORT BEACH, CA 92660 | BLUE SHIELD OF CALIFORNIA LIFE & HEALTH INSURANCE COMPANY | $744 | — | $744 | 7.54% |
| WARREN G BENDER CO3 | 516 GIBSON DRIVE, SUITE 240 ROSEVILLE, CA 95678 | BLUE SHIELD OF CALIFORNIA LIFE & HEALTH INSURANCE COMPANY | $108 | — | $108 | 1.09% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGER BENEFIT SERVICES INC | 11060 WHITE ROCK ROAD, SUITE 160 RANCHO CORDOVA, CA 95670 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $447 | — | $447 | 5.40% |
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 | 125 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 127 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA PHYSICIANS' SERVICE | 196 | $950K |
| Dental | HUMANADENTAL INSURANCE COMPANY | 118 | $47K |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 151 | $8K |
| Life insurance | BLUE SHIELD OF CALIFORNIA LIFE & HEALTH INSURANCE COMPANY | 127 | $10K |
| Prescription drug | CALIFORNIA PHYSICIANS' SERVICE | 196 | $950K |
| Other | BLUE SHIELD OF CALIFORNIA LIFE & HEALTH INSURANCE COMPANY | 127 | $10K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 196 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.