| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO OF CA INS SERVICES | 10940 WHITE ROCK ROAD RANCHO CORDOVA, CA 95670 | CALIFORNIA PHYSICIAN'S SERVICE | $87K | $2K | $89K | 3.07% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO OF CA INSURANCE SVCS | 45 FREMONT ST., SUITE 800 SAN FRANCISCO, CA 94105 | SUN LIFE ASSURANCE COMPANY OF CANADA | $5K | — | $5K | 2.21% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO OF CA INS SERVICES | 11017 COBBLEROCK DRIVE RANCHO CORDOVA, CA 95670 | SUN LIFE ASSURANCE COMPANY OF CANADA | $7K | — | $7K | 5.93% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO OF CA | P. O. BOX 39000 SAN FRANCISCO, CA 941390001 | VISION SERVICE PLAN | $1K | — | $1K | 5.21% |
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 | 254 | Currently employed and enrolled or eligible. |
| Beneficiaries receiving benefits | 1 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 254 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA PHYSICIAN'S SERVICE | 199 | $2.9M |
| Dental | SUN LIFE ASSURANCE COMPANY OF CANADA | 232 | $227K |
| Vision | VISION SERVICE PLAN | 165 | $23K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 254 | $116K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 254 | $116K |
| Prescription drug | CALIFORNIA PHYSICIAN'S SERVICE | 199 | $2.9M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 254 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.