| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE ITASCA, IL 60143 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $37K | — | $37K | 2.07% |
| LOCKTON COMPANIES, LLC3 | DEPT LA 23940 PASADENA, CA 91185 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $24K | — | $24K | 1.37% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $12K | $762 | $13K | 0.73% |
| LOCKTON COMPANIES, LLC3 | 4275 EXECUTIVE SQUARE, SUITE 600 LA JOLLA, CA 92037 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | — | $3K | $3K | 0.15% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD SUITE 600 GLENDALE, CA 91203 | KAISER FOUNDATION HEALTH PLAN INC | $8K | — | $8K | 1.76% |
| LOCKTON COMPANIES, LLC3 | 725 SOUTH FIGUEROA STREET 35TH FLOOR LOS ANGELES, CA 90017 | KAISER FOUNDATION HEALTH PLAN INC | $6K | — | $6K | 1.34% |
| MERCER HEALTH AND BENEFITS, LLC3 | 155 NORTH WACKER DRIVE, SUITE 1500 CHICAGO, IL 60606 | KAISER FOUNDATION HEALTH PLAN INC | $3K | — | $3K | 0.71% |
| LOCKTON COMPANIES, LLC3 | 4275 EXECUTIVE SQUARE, SUITE 600 LA JOLLA, CA 92037 | SYMETRA LIFE INSURANCE COMPANY | $3K | — | $3K | 4.29% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD 6TH FLOOR GLENDALE, CA 91203 | SYMETRA LIFE INSURANCE COMPANY | $3K | — | $3K | 3.91% |
| MERCER HEALTH AND BENEFITS, LLC3 | 17901 VON KARMAN AVENUE, SUITE 1100 IRVINE, CA 92614 | SYMETRA LIFE INSURANCE COMPANY | $1K | — | $1K | 1.84% |
| LEPPEK BENEFITS INC.3 Filed as: LEPPEK BENEFITS, INC. | 333 WEST HAMPDEN AVENUE, SUITE 410 ENGLEWOOD, CO 80110 | VISION SERVICE PLAN | $310 | — | $310 | 10.02% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $86 | — | $86 | 4.02% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $19 | — | $19 | 2.03% |
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 | 154 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 158 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 145 | $2.2M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 145 | $1.8M |
| Vision | VISION SERVICE PLAN | 9 | $3K |
| Life insurance(2 contracts, 2 carriers) | SYMETRA LIFE INSURANCE COMPANY | 154 | $80K |
| Short-term disability(2 contracts, 2 carriers) | SYMETRA LIFE INSURANCE COMPANY | 154 | $80K |
| Long-term disability | SYMETRA LIFE INSURANCE COMPANY | 154 | $79K |
| Prescription drug(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 145 | $2.2M |
| Other | SYMETRA LIFE INSURANCE COMPANY | 154 | $79K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 154 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.