| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 500 N SANTA FE VISALIA, CA 93292 | BLUE SHIELD OF CALIFORNIA | $0 | $46K | $46K | 3.09% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 505 NORTH BRAND BLVD SUITE 600 GLENDALE, CA 91203 | KAISER FOUNDATION HEALTH PLAN | $15K | $0 | $15K | 2.93% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF ROAD 5TH FL ROLLING MEADOW, IL 60008 | PRINCIPAL LIFE INSURANCE COMPANY | $12K | $3K | $15K | 12.76% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 505 NORTH BRAND BLVD SUITE 600 GLENDALE, CA 91203 | KAISER FOUNDATION HEALTH PLAN | $1K | $0 | $1K | 2.99% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 505 NORTH BRAND BLVD SUITE FL6 GLENDALE, CA 91203 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $0 | $3K | 10.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 2850 GOLF ROAD ROLLING MEADOW, IL 60008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $606 | $606 | 2.40% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 505 NORTH BRAND BLVD GLENDALE, CA 91203 | EYEMED VISION CARE | $2K | $0 | $2K | 9.15% |
| GALLAGHER BENEFIT SERVICES, INC. Filed as: GALLAGHER BENEFIT SERVICES INC | 505 NORTH BRAND BLVD 6TH FL GLENDALE, CA 91203 | TRANSAMERICA LIFE INSURANCE COMPANY | $6K | $0 | $6K | 57.37% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 505 NORTH BRAND BLVD GLENDALE, CA 91203 | CALIFORNIA DENTAL NETWORK | $438 | $0 | $438 | 10.00% |
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 | 183 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 5 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 194 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | BLUE SHIELD OF CALIFORNIA | 270 | $2.1M |
| Dental(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 336 | $121K |
| Vision | EYEMED VISION CARE | 748 | $17K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 183 | $25K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 183 | $25K |
| Prescription drug | BLUE SHIELD OF CALIFORNIA | 270 | $1.5M |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 183 | $35K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 748 | — |
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.