| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2 PIERCE PL FL 14 ITASCA, IL 601431203 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $1K | $1K | 0.04% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 50 BRAINTREE HILL OFFICE PARK #310 BRAINTREE, MA 021848724 | AMERITAS LIFE INSURANCE CORP. | $0 | $3K | $3K | 0.44% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON FINANCIAL ADVISORS LLC | 444 W 47TH ST STE 900 KANSAS CITY, MO 641121906 | METROPOLITAN LIFE INSURANCE COMPANY | $25K | $0 | $25K | 65.42% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 CLAIM ADMINISTRATION | Other services; Float revenue; Contract Administrator; Named fiduciary; Non-monetary compensation; Claims processing; Participant communication; Direct payment from the plan Service code 12 | ONE FRONT STREET, 7TH FLOOR SAN FRANCISCO, CA 94111 | $2.5M |
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 | 4,101 | Currently employed and enrolled or eligible. |
| Retired/separated still eligible | 45 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 4,146 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 5,426 | $19.1M |
| Dental(3 contracts, 3 carriers) | DELTA DENTAL OF CALIFORNIA | 7,222 | $5.9M |
| Vision(6 contracts) | VISION SERVICE PLAN | 2,684 | $0 |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 14,023 | $2.5M |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 14,023 | $2.5M |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 14,023 | $2.5M |
| Stop-loss / reinsurancereinsurance(2 contracts) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 5,426 | $3.2M |
| Other(2 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 14,023 | $2.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 14,023 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.