| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | KAISER FOUNDATION HEALTH PLAN INC | $33K | $0 | $33K | 4.14% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD SUITE 600 GLENDALE, CA 91203 | SUTTER HEALTH PLAN | $38K | $0 | $38K | 5.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 N BRAND BOULEVARD STE 600 GLENDALE, CA 91203 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $6K | $1K | $7K | 5.76% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | METROPOLITAN LIFE INSURANCE COMPANY | $10K | $1K | $11K | 25.68% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 1111 SUPERIOR AVE E STE 1601 CLEVELAND, OH 44114 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $5 | $5 | 0.01% |
| MASOLI LEGACY LLC4 | 588 ALEXIS CIR DALY CITY, CA 94014 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $509 | $0 | $509 | 15.66% |
| MARIAH L MASOLI4 | 588 ALEXIS CIR DALY CITY, CA 94014 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $113 | $0 | $113 | 3.48% |
| ZACHARIAH K MASOLI4 | 588 ALEXIS CIR DALY CITY, CA 94014 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $82 | $0 | $82 | 2.52% |
| SARIO CARAVALHO4 | 607 LAWTON AVE ROSEVILLE, CA 95678 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $27 | $0 | $27 | 0.83% |
| EMPLOYEE BENEFIT SPECIALIST INC4 Filed as: EMPLOYEE BENEFIT SPECIALIST | PO BOX 11657 PLESANTON, CA 94588 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $20 | $0 | $20 | 0.62% |
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 | 205 | 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) | 205 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 261 | $1.6M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 228 | $129K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 228 | $129K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 373 | $43K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 373 | $43K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 142 | $1.5M |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 373 | $46K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 373 | — |
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.