| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | GBS FINANCE SCOTTSDALE, AZ 85260 | AETNA LIFE INSURANCE CO | $195K | $0 | $195K | 2.14% |
| MARSH & MCLENNAN AGENCY LLC3 | PARK 80 WEST PLAZA 2 SADDLE BROOK, NJ 07663 | AETNA LIFE INSURANCE CO | $57K | $0 | $57K | 0.62% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, INC | 2121 N CALIFORNIA BLVD, STE 350 WALNUT CREEK, CA 94596 | KAISER FOUNDATION HEALTH PLAN INC | $28K | $0 | $28K | 1.55% |
| MARSH & MCLENNAN AGENCY LLC3 | LOCKBOX 740659 LOS ANGELES, CA 90074 | KAISER FOUNDATION HEALTH PLAN INC | $9K | $0 | $9K | 0.52% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | GBS FINANCE SCOTTSDALE, AZ 85260 | AETNA HEALTH INC. | $11K | $0 | $11K | 1.68% |
| MARSH & MCLENNAN AGENCY LLC3 | PARK 80 WEST PLAZA 2 SADDLE BROOK, NJ 07663 | AETNA HEALTH INC. | $3K | $0 | $3K | 0.52% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | RELIASTAR LIFE INSURANCE COMPANY | $41K | $0 | $41K | 6.75% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY | 2300 RENAISSANCE BLVD KING OF PRUSSIA, PA 19406 | RELIASTAR LIFE INSURANCE COMPANY | $18K | $0 | $18K | 3.03% |
| MARSH & MCLENNAN AGENCY LLC3 | 8144 WALNUT HILL LANE DALLAS, TX 75231 | RELIASTAR LIFE INSURANCE COMPANY | $6K | $0 | $6K | 1.04% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, INC | 2121 N CALIFORNIA BLVD, STE 350 WALNUT CREEK, CA 94596 | KAISER FOUNDATION HEALTH PLAN INC | $7K | $0 | $7K | 2.04% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | AETNA LIFE INSURANCE CO | $39K | $0 | $39K | 20.00% |
| MARSH & MCLENNAN AGENCY LLC3 | PARK 80 WEST PLAZA 2 250 PEHLE AVE, STE 400 SADDLE BROOK, NJ 07663 | AETNA LIFE INSURANCE CO | $13K | $0 | $13K | 6.76% |
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 | 1,072 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,075 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | AETNA LIFE INSURANCE CO | 1,509 | $11.9M |
| Dental | AETNA LIFE INSURANCE CO | 1,509 | $9.1M |
| Vision | VISION SERVICE PLAN | 750 | $89K |
| Life insurance | RELIASTAR LIFE INSURANCE COMPANY | 1,763 | $608K |
| Short-term disability | RELIASTAR LIFE INSURANCE COMPANY | 1,763 | $608K |
| Long-term disability | RELIASTAR LIFE INSURANCE COMPANY | 1,763 | $608K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 191 | $1.8M |
| Other | RELIASTAR LIFE INSURANCE COMPANY | 1,763 | $608K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,763 | — |
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.