| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $42K | — | $42K | 1.67% |
| LEAVITT GROUP3 Filed as: LEAVITT INSURANCE SVCS OF LA | 21820 BURBANK BLVD SUITE 300 WOODLAND HILLS, CA 91367 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $20K | — | $20K | 0.82% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS & FIN SVC LLC | 12404 PARK CENTRAL DR SUITE #400S DALLAS, TX 75251 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | — | $19K | $19K | 0.76% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 21820 BURBANK BLVD., SUITE 300 WOODLAND HILLS, CA 91367 | KAISER FOUNDATION HEALTH PLAN, INC. | $50K | — | $50K | 3.67% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 21820 BURBANK BLVD SUITE 301 WOODLAND HILLS, CA 91367 | METROPOLITAN LIFE INSURANCE COMPANY | $21K | $54 | $21K | 8.34% |
| LEAVITT GROUP3 Filed as: LEAVITT INSURANCE SERVICES OF LA | 21820 BURBANK BLVD., SUITE 300 WOODLAND HILLS, CA 91367 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $16 | $4K | 1.67% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 95287 CHICAGO, IL 60690 | METROPOLITAN LIFE INSURANCE COMPANY | — | $3K | $3K | 1.08% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | SUN LIFE ASSURANCE COMPANY OF CANADA | $21K | $4K | $24K | 14.42% |
| LEAVITT GROUP3 Filed as: LEAVITT INSURANCE SERVICES OF LA | 2190 NORTH LOOP W STE 309 HOUSTON, TX 77018 | SUN LIFE ASSURANCE COMPANY OF CANADA | $4K | — | $4K | 2.55% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 21820 BURBANK BLVD SUITE 301 WOODLAND HILLS, CA 91367 | TRUSTMARK INSURANCE COMPANY | $6K | — | $6K | 15.99% |
| LEAVITT GROUP3 Filed as: LEAVITT INSURANCE SVCS OF LA | 21820 BURBANK BLVD SUITE 301 WOODLAND HILLS, CA 91367 | TRUSTMARK INSURANCE COMPANY | $2K | — | $2K | 5.29% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 21820 BURBANK BLVD SUITE 301 WOODLAND HILLS, CA 91367 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $1K | — | $1K | 8.48% |
| LEAVITT GROUP3 Filed as: LEAVITT INSURANCE SERVICES OF LA | 21820 BURBANK BLVD., SUITE 300 WOODLAND HILLS, CA 91367 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $208 | — | $208 | 1.62% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 95287 CHICAGO, IL 60690 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | — | $143 | $143 | 1.11% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 15.00% |
| LEAVITT GROUP3 Filed as: LEAVITT INSURANCE SERVICES OF LA | 21820 BURBANK BLVD., SUITE 300 WOODLAND HILLS, CA 91367 | TRUSTMARK INSURANCE COMPANY | $307 | — | $307 | 4.98% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $231 | — | $231 | 14.99% |
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 | 286 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 287 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 227 | $3.8M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 605 | $261K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 227 | $2.5M |
| Life insurance(3 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 312 | $212K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 312 | $170K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 312 | $170K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN, INC. | 156 | $1.4M |
| Other(5 contracts, 3 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 312 | $222K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 605 | — |
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.