| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 18201 VON KARMAN AVENUE, SUITE 200 IRVINE, CA 92612 | CALIFORNIA PHYSICIANS SERVICE | $56K | $0 | $56K | 5.00% |
| PAM J RAGUS3 Filed as: PAM JEAN RAGUS | 130 NORTH BRAND BOULEVARD SUITE 310 GLENDALE, CA 91203 | CALIFORNIA PHYSICIANS SERVICE | $0 | $21K | $21K | 1.88% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 18201 VON KARMAN AVENUE, SUITE 200 IRVINE, CA 92612 | KAISER FOUNDATION HEALTH PLAN, INC. | $20K | $0 | $20K | 5.23% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $9K | $0 | $9K | 7.49% |
| PROFESSIONAL GROUP PLANS INC3 Filed as: PROFESSIONAL GROUP PLANS, INC. | 225 WIRELESS BOULEVARD, SUITE 200 HAUPPAUGE, NY 11788 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $0 | $6K | $6K | 4.95% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $3K | $0 | $3K | 2.41% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 18201 VON KARMAN AVENUE IRVINE, CA 92612 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $8K | $0 | $8K | 13.79% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB HEARTLAND, LLC | 6805 AVERY-MUIRFIELD DRIVE DUBLIN, OH 43016 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $4K | $4K | 6.44% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $2K | $921 | $3K | 19.00% |
| ARCHON LLC3 Filed as: ARCHON, LLC | 225 WIRELESS BOULEVARD, 2ND FLOOR HAUPPAUGE, NY 11788 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $0 | $803 | $803 | 4.58% |
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 | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 183 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 130 | $1.5M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 143 | $125K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 143 | $125K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 183 | $61K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 183 | $61K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 183 | $61K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 130 | $1.5M |
| Other(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 183 | $78K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 183 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.