| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 21ST FLOOR ITASCA, IL 60143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $203K | $0 | $203K | 12.49% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $20K | $20K | 1.22% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 11060 WHITE ROCK ROAD, SUITE 160 RANCHO CORDOVA, CA 95670 | WESTERN HEALTH ADVANTAGE | $57K | $0 | $57K | 5.00% |
| EMPLOYERS NATIONAL EXPERT RESOURCE3 Filed as: EMPLOYERS NATIONAL EXPERT RES. GRP. | 33302 VALLE ROAD, SUITE 250 SAN JUAN CAPISTRANO, CA 92675 | KAISER FOUNDATION HEALTH PLAN INC | $16K | $0 | $16K | 4.59% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 1900 WEST LOOP SOUTH, SUITE 1600 HOUSTON, TX 77027 | VISION SERVICE PLAN | $5K | $0 | $5K | 1.46% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE ITASCA, IL 60143 | KAISER FOUNDATION HEALTH PLAN INC | $8K | $0 | $8K | 4.28% |
| EMPLOYERS NATIONAL EXPERT RESOURCE3 Filed as: EMPLOYERS NATIONAL EXPERT RES. GRP. | 33302 VALLE ROAD, SUITE 250 SAN JUAN CAPISTRANO, CA 92675 | KAISER FOUNDATION HEALTH PLAN INC | $3K | $0 | $3K | 1.43% |
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 | 5,411 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 22 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 5,433 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | WESTERN HEALTH ADVANTAGE | 288 | $1.7M |
| Vision | VISION SERVICE PLAN | 3,701 | $309K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,264 | $1.6M |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,264 | $1.6M |
| Prescription drug(3 contracts, 2 carriers) | WESTERN HEALTH ADVANTAGE | 288 | $1.7M |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,264 | $1.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,701 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.