| 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 OF CALIFORNIA | $138K | $4K | $142K | 4.87% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN INSURANCE ADMIN., INC. | 721 SOUTH PARKER STREET ORANGE, CA 92868 | BLUE CROSS OF CALIFORNIA | $0 | $52K | $52K | 1.79% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2121 NORTH CALIFORNIA BOULEVARD SUITE 350 WALNUT CREEK, CA 94596 | KAISER FOUNDATION HEALTH PLAN, INC. | $47K | $0 | $47K | 5.95% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 500 NORTH BRAND BOULEVARD SUITE 100 GLENDALE, CA 91203 | ANTHEM LIFE INSURANCE COMPANY | $8K | $0 | $8K | 5.62% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | VISION SERVICE PLAN | $2K | — | $2K | 3.66% |
| ENROLLEASE3 Filed as: ENROLLEASE, INC. | 1980 FESTIVAL PLAZA DRIVE, SUTE 810 LAS VEGAS, NV 89135 | VISION SERVICE PLAN | -$201 | — | -$201 | -0.40% |
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 | 230 | 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) | 231 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 479 | $3.7M |
| Dental | BLUE CROSS OF CALIFORNIA | 479 | $2.9M |
| Vision | VISION SERVICE PLAN | 210 | $51K |
| Life insurance | ANTHEM LIFE INSURANCE COMPANY | 250 | $143K |
| Short-term disability | ANTHEM LIFE INSURANCE COMPANY | 250 | $143K |
| Long-term disability | ANTHEM LIFE INSURANCE COMPANY | 250 | $143K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 479 | $3.7M |
| Other(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 479 | $3.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 479 | — |
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.