| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | KAISER FOUNDATION HEALTH PLAN INC | $24K | $0 | $24K | 3.57% |
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS, LLC | 1850 GATEWAY DRIVE, SUITE 600 SAN MATEO, CA 94404 | KAISER FOUNDATION HEALTH PLAN INC | $0 | $2K | $2K | 0.23% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 1255 BATTERY STREET, SUITE 450 SAN FRANCISCO, CA 94111 | DELTA DENTAL OF CALIFORNIA | $7K | $0 | $7K | 5.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 1255 BATTERY STREET, SUITE 450 SAN FRANCISCO, CA 94111 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | $0 | $4K | 10.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | VISION SERVICE PLAN | $1K | $0 | $1K | 5.67% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 11060 WHITE ROCK ROAD, SUITE 160 RANCHO CORDOVA, CA 95670 | CLAREMONT EAP | $257 | $0 | $257 | 5.01% |
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 | 150 | 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) | 150 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 119 | $663K |
| Dental | DELTA DENTAL OF CALIFORNIA | 269 | $135K |
| Vision | VISION SERVICE PLAN | 137 | $19K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 115 | $43K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 115 | $43K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 115 | $43K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 119 | $663K |
| Other(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 150 | $49K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 269 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.