| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 1255 BATTERY STREET, SUITE 450 SAN FRANCISCO, CA 94111 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $211K | — | $211K | 3.17% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE ITASCA, IL 60143 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | — | $4K | $4K | 0.06% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 1255 BATTERY STREET, SUITE 450 SAN FRANCISCO, CA 94111 | CIGNA HEALTHCARE OF CALIFORNIA | $63K | — | $63K | 2.52% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE ITASCA, IL 60143 | KAISER FOUNDATION HEALTH PLAN INC | $42K | — | $42K | 1.69% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 8059 WALNUT CREEK, CA 94596 | HARTFORD LIFE AND ACCIDENT | $57K | — | $57K | 10.91% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 295 WOODLIFF DRIVE, SUITE 101 FAIRPORT, NY 14450 | HARTFORD LIFE AND ACCIDENT | $3K | — | $3K | 0.57% |
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 | 690 | 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) | 690 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 848 | $12.0M |
| Dental | DELTA DENTAL OF CALIFORNIA | 100 | $21K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 690 | $521K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 690 | $521K |
| Prescription drug(4 contracts, 4 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 848 | $12.0M |
| Other(4 contracts, 4 carriers) | HARTFORD LIFE AND ACCIDENT | 690 | $633K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 848 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.