| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD SUITE 600 GLENDALE, CA 91203 | UNITEDHEALTHCARE INSURANCE COMPANY | $80K | $11K | $91K | 4.56% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD SUITE 600 GLENDALE, CA 91203 | KAISER FOUNDATION HEALTH PLAN INC | $10K | $0 | $10K | 3.24% |
| MERCER HEALTH AND BENEFITS, LLC3 | 155 NORTH WACKER DRIVE, SUITE 1500 CHICAGO, IL 60606 | KAISER FOUNDATION HEALTH PLAN INC | $2K | $0 | $2K | 0.50% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 369 SOUTH ARIZONA AVENUE, SUITE A CHANDLER, AZ 85225 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $10K | $0 | $10K | 6.00% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | $0 | $5K | 6.34% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | $135 | $4K | 5.69% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD SUITE 600 GLENDALE, CA 91203 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $3K | $0 | $3K | 8.43% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD SUITE 600 GLENDALE, CA 91203 | METLIFE LEGAL PLANS | $708 | $75 | $783 | 11.06% |
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 | 169 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 6 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 177 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 350 | $2.3M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 169 | $160K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 339 | $32K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 169 | $72K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 169 | $72K |
| Prescription drug(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 350 | $2.3M |
| Other(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 169 | $79K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 350 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.