| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | UNKNOWN PHOENIX, AZ 85012 | AETNA LIFE INSURANCE COMPANY | $47K | $0 | $47K | 3.71% |
| USI INSURANCE SERVICES LLC3 | 1000 BURNETT AVENUE, SUITE 330 CONCORD, CA 94520 | AETNA LIFE INSURANCE COMPANY | $16K | $0 | $16K | 1.25% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2121 NORTH CALIFORNIA BOULEVARD SUITE 350 WALNUT CREEK, CA 94596 | KAISER FOUNDATION HEALTH PLAN INC | $13K | $0 | $13K | 3.18% |
| USI INSURANCE SERVICES LLC3 | 150 NORTH MICHIGAN AVENUE SUITE 3900 CHICAGO, IL 60601 | KAISER FOUNDATION HEALTH PLAN INC | $7K | $0 | $7K | 1.73% |
| GALLAGHER BENEFIT SERVICES, INC.3 | UNKNOWN PHOENIX, AZ 85012 | AETNA HEALTH OF CALIFORNIA, INC. | $5K | $0 | $5K | 2.94% |
| USI INSURANCE SERVICES LLC3 | 1000 BURNETT AVENUE, SUITE 330 CONCORD, CA 94520 | AETNA HEALTH OF CALIFORNIA, INC. | $3K | $0 | $3K | 1.59% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $2K | $6K | 9.22% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $0 | $2K | 3.31% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | VISION SERVICE PLAN | $888 | $0 | $888 | 3.34% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $692 | $0 | $692 | 2.60% |
| BALTOR INSURANCE SERVICES3 | 533 AIRPORT BOULEVARD, SUITE 400 BURLINGAME, CA 94010 | AFLAC | $280 | $35 | $315 | 3.80% |
| MJ INSURANCE3 Filed as: CHRIS NESTER AND VARIOUS AGENTS | 1610 PARK TRAIL DRIVE HOLLISTER, CA 95023 | AFLAC | $221 | $0 | $221 | 2.66% |
| BONNIE C. SATO3 Filed as: BONNIE SATO | 2515 MUIRFIELD WAY GILROY, CA 95020 | AFLAC | $54 | $0 | $54 | 0.65% |
| RUBEN ROSA3 | 933 LEE ROAD, SUITE 200 ORLANDO, FL 32810 | AFLAC | $44 | $8 | $52 | 0.63% |
| SHELLY DENISE CAIRES3 Filed as: SHELLY CAIRES | 220 CASCADE DRIVE HIGH POINT, NC 27265 | AFLAC | $50 | $0 | $50 | 0.60% |
| JOSHUA BALTOR3 | 533 AIRPORT BOUELVARD, SUITE 400 BURLINGAME, CA 94010 | AFLAC | $50 | $0 | $50 | 0.60% |
| DANA L. REED3 Filed as: DANA REED | 2021 KOOPMANS AVENUE SANTA CRUZ, CA 95062 | AFLAC | $49 | $0 | $49 | 0.59% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 14TH FLOOR ITASCA, IL 60143 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $130 | $0 | $130 | 2.62% |
| GALLAGHER BENEFIT SERVICES, INC.3 | UNKNOWN SANTA CLARA, CA 95054 | CLAREMONT BEHAVIORAL SERVICES, INC. | $194 | $0 | $194 | 4.99% |
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 | 123 | 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) | 123 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | AETNA LIFE INSURANCE COMPANY | 131 | $1.8M |
| Dental | AFLAC | 7 | $8K |
| Vision | VISION SERVICE PLAN | 106 | $27K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 124 | $69K |
| Short-term disability(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 124 | $77K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 124 | $69K |
| Prescription drug(4 contracts, 4 carriers) | AETNA LIFE INSURANCE COMPANY | 131 | $1.8M |
| Other(3 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 124 | $81K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 131 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.