| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | TWO PIERCE PLACE 14TH FLOOR ITASCA, IL 60143 | AETNA LIFE INSURANCE COMPANY | $198K | $16K | $213K | 4.53% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3095 ARLINGTON HEIGHTS, IL 60006 | AETNA LIFE INSURANCE COMPANY | $39K | $0 | $39K | 0.83% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | KAISER FOUNDATION HEALTH PLAN INC | $46K | $3 | $46K | 4.56% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | KAISER FOUNDATION HEALTH PLAN INC | $37K | $2 | $37K | 4.55% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF ROAD 11TH FLOOR ROLLING MEADOWS, IL 60008 | PRINCIPAL LIFE INSURANCE COMPANY | $43K | $0 | $43K | 5.47% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 2185 N CALIFORNIA BLVD SUITE 400 WALNUT CREEK, CA 94596 | HOMETOWN HEALTH | $25K | $0 | $25K | 5.29% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 906 WEST 2ND AVENUE SUITE 400 SPOKANE, WA 99201 | AETNA LIFE INSURANCE COMPANY | $16K | $0 | $16K | 4.65% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 777 108TH AVENUE NE SUITE 200 BELLEVUE, WA 98004 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $2K | $0 | $2K | 3.03% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | TWO PIERCE PLACE 21ST FL ITASCA, IL 60143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $10K | $0 | $10K | 14.58% |
| D A FINANCIAL INS SERVICES INC3 | 3470 MOUNT DIABLO BOULEVARD SUITE A100 LAFAYETTE, CA 94549 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $67 | $0 | $67 | 0.10% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 1255 BATTERY STREET SUITE 450 SAN FRANCISCO, CA 94111 | AMERITAS LIFE INSURANCE CORPORATION | $1K | $0 | $1K | 7.67% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF ROAD FL 21 ROLLING MEADOWS, IL 60008 | AMERITAS LIFE INSURANCE CORPORATION | $0 | $80 | $80 | 0.42% |
| D A FINANCIAL INS SERVICES INC3 | 3470 MOUNT DIABLO BOULEVARD SUITE A100 LAFAYETTE, CA 94549 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $17 | $0 | $17 | 1.49% |
| JOHN A. HOHMAN3 Filed as: JOHN ANDREW HOHMAN | 3470 MOUNT DIABLO BOULEVARD SUITE A100 LAFAYETTE, CA 94549 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $6 | $1 | $7 | 0.62% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | TWO PIERCE PLACE 21ST FLOOR ITASCA, IL 60143 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $7 | $0 | $7 | 0.62% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF ROAD 11TH FLOOR ROLLING MEADOWS, IL 60008 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $1 | $1 | 0.09% |
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 | 1,002 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 75 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 30 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,107 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(8 contracts, 5 carriers) | AETNA LIFE INSURANCE COMPANY | 426 | $8.5M |
| Dental(3 contracts, 3 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 180 | $998K |
| Vision | HAWAII MEDICAL SERVICE ASSOCIATION | 180 | $965K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 1,002 | $782K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 1,002 | $782K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 1,002 | $782K |
| Prescription drug(6 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 180 | $3.4M |
| Other(4 contracts, 4 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 1,002 | $876K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,002 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.