| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | KAISER FOUNDATION HEALTH PLAN REGION MA | $3K | — | $3K | 0.48% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | HARTFORD LIFE AND ACCIDENT | $8K | $10K | $17K | 3.21% |
| AON CONSULTING INC3 | 29840 NETWORK PLACE CHICAGO, IL 606731299 | HARTFORD LIFE AND ACCIDENT | $668 | $4K | $4K | 0.80% |
| AON CONSULTING INC3 Filed as: AON RISK SERVICES CENTRAL INC | PO BOX 955816 SAINT LOUIS, MO 63195 | HARTFORD LIFE AND ACCIDENT | — | $2K | $2K | 0.46% |
| AON CONSULTING INC3 Filed as: AON CONSULTING | 29840 NETWORK PL CHICAGO, IL 606731298 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $10K | $14K | 5.74% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 1900 WEST LOOP S STE 1600 HOUSTON, TX 770273295 | METROPOLITAN LIFE INSURANCE COMPANY | $8K | $5 | $8K | 3.32% |
| GALLAGHER BENEFIT SERVICES, INC.1 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 600063009 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $8K | $8K | 3.32% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 1111 SUPERIOR AVE E STE 1601 CLEVELAND, OH 441142522 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $87 | $87 | 0.03% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 444 W 47TH ST, STE 900 KANSAS CITY, MO 64112 | MONUMENTAL LIFE INSURANCE COMPANY | $2K | — | $2K | 6.44% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| GSA NATIONAL EIN 11-3335620 THIRD PARTY ADMINISTRATOR | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $770K |
| ANTHEM BLUE CROSS AND BLUE SHIELD EIN 58-1638390 CLAIM PROCESSING | Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Float revenue; Claims processing Service code 12 | — | $745K |
| AMERIBEN / IEC GROUP EIN 82-0497661 CLAIM PROCESSING | Contract Administrator; Claims processing Service code 12 | — | $439K |
| 2ND.MD CLAIM PROCESSING | Claims processing; Contract Administrator Service code 12 | 9655 KATY FREEWAY, SUITE 300 HOUSTON, TX 77024 | $70K |
| METROPOLITAN LIFE INSURANCE COMPANY EIN 13-5581829 CLAIM PROCESSING | Claims processing; Contract Administrator Service code 12 | — | $58K |
| ZELIS CLAIMS INTEGRITY INC. CLAIM PROCESSING | Direct payment from the plan; Claims processing Service code 12 | 2 CROSSROADS DRIVE BEDMINSTER, NJ 07921 | $57K |
| OPTUMRX, INC. EIN 33-0441200 PHARMACY BENEFIT MGMT | Direct payment from the plan; Claims processing; Float revenue; Other fees Service code 12 | — | $30K |
| ALIGHT SOLUTIONS LLC EIN 82-1061233 THIRD PARTY ADMINISTRATOR | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $15K |
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 | 2,866 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 2,866 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(9 contracts, 9 carriers) | KAISER FOUNDATION HEALTH PLAN INC - SCA | 88 | $1.7M |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 2,865 | $251K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 3,659 | $539K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 3,659 | $539K |
| Stop-loss / reinsurancereinsurance | HM LIFE INSURANCE COMPANY | 1,648 | $269K |
| Other(12 contracts, 12 carriers) | KAISER FOUNDATION HEALTH PLAN INC - SCA | 3,659 | $2.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,659 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.