| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 1 ALMADEN BOULEVARD, SUITE 960 SAN JOSE, CA 95113 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $431K | $0 | $431K | 3.04% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 21ST FLOOR ITASCA, IL 60143 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $0 | $8K | $8K | 0.06% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 3697 MOUNT DIABLO BOULEVARD SUITE 300 LAFAYETTE, CA 94549 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | -$30K | $0 | -$30K | -0.21% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 3697 MOUNT DIABLO BOULEVARD SUITE 300 LAFAYETTE, CA 94549 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $75 | $75 | 0.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 1255 BATTERY STREET, SUITE 450 SAN FRANCISCO, CA 94111 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $142K | $0 | $142K | 18.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 100 SMITH RANCH ROAD, SUITE 120 SAN RAFAEL, CA 94903 | CONCERN EAP | $5K | $0 | $5K | 5.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 100 SMITH RANCH ROAD, SUITE 112 SAN RAFAEL, CA 94903 | HYATT LEGAL PLANS | $7K | $0 | $7K | 9.37% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 101 LARKSPUR LANDING CIRCLE SUITE 120 LARKSPUR, CA 94939 | HYATT LEGAL PLANS | $0 | $75 | $75 | 0.11% |
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 | 2,287 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 56 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 52 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,395 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 5 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 2,321 | $24.4M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 3,792 | $3.5M |
| Vision(2 contracts, 2 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 1,784 | $1.7M |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 2,178 | $790K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 2,178 | $790K |
| Prescription drug(5 contracts, 5 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 2,321 | $24.4M |
| Other(4 contracts, 4 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 3,635 | $981K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,792 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.