| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE ITASCA, IL 60143 | KAISER FOUNDATION HEALTH PLAN, INC. | $39K | $0 | $39K | 0.29% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | HARTFORD LIFE AND ACCIDENT | $450K | $136K | $586K | 8.30% |
| LOCKTON COMPANIES, LLC3 | 2100 ROSS AVENUE, SUITE 1200 DALLAS, TX 75201 | HARTFORD LIFE AND ACCIDENT | $0 | $2K | $2K | 0.03% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 323 WEST LAKESIDE AVENUE, SUITE 410 CLEVELAND, OH 44113 | BLUE CROSS OF CALIFORNIA | $0 | $3K | $3K | 0.08% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 1900 WEST LOOP SOUTH, SUITE 1600 HOUSTON, TX 77027 | LIFE INSURANCE OF NORTH AMERICA | $0 | $156K | $156K | 5.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 5TH FLOOR ROLLING MEADOWS, IL 60008 | LIFE INSURANCE OF NORTH AMERICA | $0 | $36K | $36K | 1.15% |
| LOCKTON COMPANIES, LLC3 | PO BOX 123042, DEPARTMENT 3042 DALLAS, TX 75312 | LIFE INSURANCE OF NORTH AMERICA | $0 | $20K | $20K | 0.64% |
| ACRISURE LLC3 Filed as: FULCRO INSURANCE | UNKNOWN HOUSTON, TX 77019 | TRIPLE S SALUD, INC | $40K | $0 | $40K | 4.95% |
| CGF INSURANCE LLC3 Filed as: CGF INSURANCE | 22 AVENIDA GONZALEZ GUIUSTI SUITE 200 GUAYNABO, PR 00968 | DELTA DENTAL OF PUERTO RICO, INC. | $1K | $0 | $1K | 2.72% |
| ACRISURE LLC3 Filed as: FULCRO INSURANCE | UNKNOWN HOUSTON, TX 77019 | DELTA DENTAL OF PUERTO RICO, INC. | $918 | $0 | $918 | 2.29% |
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 | 15,779 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 111 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 290 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 16,180 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 1,393 | $17.8M |
| Dental(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 1,566 | $382K |
| Vision | VISION SERVICE PLAN | 9,262 | $1.2M |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 15,779 | $7.1M |
| Long-term disability | LIFE INSURANCE OF NORTH AMERICA | 15,779 | $3.1M |
| Prescription drug(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 1,393 | $17.8M |
| Other | HARTFORD LIFE AND ACCIDENT | 15,779 | $7.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 15,779 | — |
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."
No prospect flags tripped on this filing.