| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 323 WEST LAKESIDE AVENUE, SUITE 410 CLEVELAND, OH 44113 | BLUE CROSS OF CALIFORNIA | $119K | $3K | $122K | 5.96% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD AND BROWN INS. ADMIN., INC. | 721 SOUTH PARKER STREET ORANGE, CA 92868 | BLUE CROSS OF CALIFORNIA | $0 | $47K | $47K | 2.31% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD SUITE 100 GLENDALE, CA 91203 | KAISER FOUNDATION HEALTH PLAN, INC. | $17K | $0 | $17K | 4.11% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD AND BROWN INS. ADMIN., INC. | 721 SOUTH PARKER STREET, SUITE 200 ORANGE, CA 92868 | KAISER FOUNDATION HEALTH PLAN, INC. | -$6 | $0 | -$6 | -0.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | KAISER FOUNDATION HEALTH PLAN, INC. | -$14 | — | -$14 | -0.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 323 WEST LAKESIDE AVENUE, SUITE 410 CLEVELAND, OH 44113 | STANDARD INSURANCE COMPANY | $13K | $2K | $15K | 15.95% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD AND BROWN INS. ADMIN., INC. | 721 SOUTH PARKER STREET ORANGE, CA 92868 | STANDARD INSURANCE COMPANY | $0 | $4K | $4K | 4.59% |
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 | 158 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 168 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 309 | $2.5M |
| Dental | BLUE CROSS OF CALIFORNIA | 309 | $2.0M |
| Vision | BLUE CROSS OF CALIFORNIA | 309 | $2.0M |
| Life insurance(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 177 | $103K |
| Short-term disability(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 177 | $103K |
| Long-term disability(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 177 | $103K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 309 | $2.5M |
| Other(3 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 309 | $2.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 309 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.