| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WELLS FARGO INSURANCE SERVICES3 | 150 NORTH MICHIGAN AVENUE SUITE 3900 CHICAGO, IL 60601 | KAISER FOUNDATION HEALTH PLAN INC | $22K | — | $22K | 3.21% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 959 SKYWAY ROAD, 2ND FLOOR SAN CARLOS, CA 94070 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $19K | — | $19K | 9.91% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 45 FREEMONT STREET, SUITE 800 SAN FRANCISCO, CA 94105 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $4K | $4K | 1.84% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 959 SKYWAY ROAD, 2ND FLOOR SAN CARLOS, CA 94070 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $7K | $1K | $9K | 11.80% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 959 SKYWAY ROAD, SUITE 200 SAN CARLOS, CA 94070 | VISION SERVICE PLAN | $1K | — | $1K | 4.72% |
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 | 407 | 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) | 407 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 277 | $895K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 277 | $195K |
| Vision | VISION SERVICE PLAN | 252 | $29K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 407 | $74K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 407 | $74K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 407 | $74K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 175 | $700K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 407 | $74K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 407 | — |
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.