| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $153K | — | $153K | 9.47% |
| GALLAGHER BENEFIT SERVICES, INC.3 | ONE COMMERCE SQUARE 2005 MARKET STREET PHILADELPHIA, PA 19103 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $41K | — | $41K | 2.57% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $477 | $477 | 0.03% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | AETNA LIFE INSURANCE COMPANY | $85K | — | $85K | 20.98% |
| CHRISTA G AUFDEMBERG INC4 Filed as: CHRISTA G. AUFDEMBERG, INC. | 13102 BRITTANY WOODS DRIVE TUSTIN, CA 92780 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $200 | — | $200 | 4.33% |
| MARIA SCHWARTZ4 | 312 VIA PROMESA SAN CLEMENTE, CA 92673 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $93 | $0 | $93 | 2.01% |
| MICHELLE WALTERS4 | 23825 NORTH 65TH DRIVE GLENDALE, AZ 85310 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $61 | — | $61 | 1.32% |
| SANDRA SIMS3 Filed as: SANDRA ALLEN | 501 AGUAPLACE SEAK BEACH, CA 90740 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $59 | $0 | $59 | 1.28% |
| AMY EVANS4 | 1751 COLORADO BOULEVARD LOS ANGELES, CA 90041 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $45 | — | $45 | 0.97% |
| LONDONO MILLER BENEFITS INC3 Filed as: LONDONO MILLER BENEFITS, INC. | 28326 ATLEY COURT SAUGUS, CA 91350 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $35 | $0 | $35 | 0.76% |
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 | 2,398 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 17 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,415 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN, INC. | 981 | $7.0M |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 1,736 | $205K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 2,398 | $1.6M |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 2,398 | $1.6M |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN, INC. | 981 | $7.0M |
| Other(3 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 2,398 | $2.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,398 | — |
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.