| 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 CALIFORNIA | $22K | $2 | $22K | 2.05% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INS BROKERAGE, INC. | 2101 FLORENCE AVENUE CINCINNATI, OH 45206 | BLUE CROSS CALIFORNIA | $8K | $0 | $8K | 0.73% |
| ADVOCATE, INC.3 Filed as: ADVOCATE NAVA BENEFITS | 228 PARK AVENUE SOUTH NEW YORK, NY 10003 | BLUE CROSS CALIFORNIA | $8K | $0 | $8K | 0.72% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 21820 BURBANK BOULEVARD, SUITE 300 WOODLAND HILLS, CA 91367 | KAISER FOUNDATION HEALTH PLAN, INC | $10K | $0 | $10K | 3.16% |
| ADVOCATE, INC.3 | 228 PARK AVENUE SOUTH NEW YORK, NY 10003 | KAISER FOUNDATION HEALTH PLAN, INC | $5K | $0 | $5K | 1.59% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 2270 DOUGLAS BOULEVARD, SUITE 220 ROSEVILLE, CA 95661 | KAISER FOUNDATION HEALTH PLAN, INC | $3K | $0 | $3K | 1.04% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 500 NORTH BRAND BOULEVARD GLENDALE, CA 91203 | HUMANA INSURANCE COMPANY | $7K | $0 | $7K | 5.27% |
| ADVOCATE, INC.3 | 295 LAFAYETTE STREET, 7TH FLOOR NEW YORK, NY 10012 | HUMANA INSURANCE COMPANY | $3K | $0 | $3K | 2.62% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 160 FEDERAL STREET, 2ND FLOOR BOSTON, MA 02110 | HUMANA INSURANCE COMPANY | $2K | $0 | $2K | 1.70% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 5TH FLOOR ROLLING MEADOWS, IL 60008 | HUMANA INSURANCE COMPANY | $0 | $1K | $1K | 0.82% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS & FIN SER | 12404 PARK CENTRAL DRIVE SUITE 400S DALLAS, TX 75251 | HUMANA INSURANCE COMPANY | $0 | $170 | $170 | 0.13% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 500 NORTH BRAND BOULEVARD SUITE 100 GLENDALE, CA 91203 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | $0 | $8K | 8.40% |
| ADVOCATE, INC.3 | 228 PARK AVENUE SOUTH, PMB 97880 NEW YORK, NY 10003 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $521 | $5K | 5.36% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 2040 MAIN STREET, SUITE 450 IRVINE, CA 92614 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $290 | $3K | 3.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 WEST GOLF ROAD ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $2K | $2K | 2.19% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 500 NORTH BRAND BOULEVARD SUITE 100 GLENDALE, CA 91203 | UNUM LIFE INSURANCE COMPANY | $4K | $0 | $4K | 14.77% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 WEST GOLF ROAD ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY | $0 | $1K | $1K | 4.92% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 2040 MAIN STREET, SUITE 450 IRVINE, CA 92614 | UNUM LIFE INSURANCE COMPANY | $54 | $7 | $61 | 0.20% |
| ADVOCATE, INC.3 | 228 PARK AVENUE SOUTH, PMB 97880 NEW YORK, NY 10003 | UNUM LIFE INSURANCE COMPANY | $18 | $2 | $20 | 0.07% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 500 NORTH BRAND BOULEVARD GLENDALE, CA 91203 | HUMANADENTAL INSURANCE COMPANY | $452 | $0 | $452 | 5.53% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 5TH FLOOR ROLLING MDWS, IL 60008 | HUMANADENTAL INSURANCE COMPANY | $0 | $217 | $217 | 2.65% |
| ADVOCATE, INC.3 | 295 LAFAYETTE STREET, 7TH FLOOR NEW YORK, NY 10012 | HUMANADENTAL INSURANCE COMPANY | $207 | $0 | $207 | 2.53% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 160 FEDERAL STREET, 2ND FLOOR BOSTON, MA 02110 | HUMANADENTAL INSURANCE COMPANY | $142 | $0 | $142 | 1.74% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS & FIN SER | 12404 PARK CENTRAL DRIVE SUITE 400S DALLAS, TX 75251 | HUMANADENTAL INSURANCE COMPANY | $0 | $36 | $36 | 0.44% |
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 | 181 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 181 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS CALIFORNIA | 170 | $1.4M |
| Dental(2 contracts, 2 carriers) | HUMANA INSURANCE COMPANY | 185 | $139K |
| Vision | HUMANA INSURANCE COMPANY | 185 | $131K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 181 | $100K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 181 | $100K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 181 | $100K |
| Prescription drug | BLUE CROSS CALIFORNIA | 170 | $1.1M |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 181 | $130K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 185 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.