| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE ITASCA, IL 60143 | BLUE CROSS OF CALIFORNIA | $127K | $0 | $127K | 1.99% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | KAISER FOUNDATION HEALTH PLAN INC | $43K | $0 | $43K | 1.09% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 18201 VON KARMAN, SUITE 200 IRVINE, CA 92612 | AETNA LIFE INSURANCE COMPANY | $14K | $88 | $14K | 1.97% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 1255 BATTERY STREET, SUITE 450 SAN FRANCISCO, CA 94111 | HARTFORD LIFE AND ACCIDENT | $42K | $0 | $42K | 10.40% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | HARTFORD LIFE AND ACCIDENT | $0 | $3K | $3K | 0.62% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 1255 BATTERY STREET, SUITE 450 SAN FRANCISCO, CA 94111 | SIMNSA | $14K | $0 | $14K | 7.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | VISION SERVICE PLAN | $2K | $0 | $2K | 2.63% |
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 | 1,900 | 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) | 1,900 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 5 carriers) | BLUE CROSS OF CALIFORNIA | 1,039 | $13.6M |
| Dental(4 contracts, 4 carriers) | AETNA LIFE INSURANCE COMPANY | 1,780 | $1.1M |
| Vision(3 contracts, 3 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 949 | $3.1M |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 1,175 | $404K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 1,175 | $404K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 1,175 | $404K |
| Prescription drug(5 contracts, 5 carriers) | BLUE CROSS OF CALIFORNIA | 1,039 | $13.6M |
| Other | HARTFORD LIFE AND ACCIDENT | 1,175 | $404K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,780 | — |
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.