| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 4100 NEWPORT PLACE DRIVE, SUITE 650 NEWPORT BEACH, CA 92660 | CALIFORNIA PHYSICIANS' SERVICE | $95K | $2K | $98K | 3.07% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE ITASCA, IL 60143 | KAISER FOUNDATION HEALTH PLAN INC | $40K | — | $40K | 3.96% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 14TH FLOOR ITASCA, IL 60143 | KAISER FOUNDATION HEALTH PLAN INC | — | $942 | $942 | 0.09% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 1255 BATTERY STREET, SUITE 450 SAN FRANCISCO, CA 94111 | DELTA DENTAL OF CALIFORNIA | $15K | — | $15K | 4.19% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 21ST FLOOR ITASCA, IL 60143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $26K | — | $26K | 10.55% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 14TH FLOOR ITASCA, IL 60143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $3K | $3K | 1.25% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 14TH FLOOR ITASCA, IL 60143 | VISION SERVICE PLAN | $2K | — | $2K | 3.46% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 14TH FLOOR ITASCA, IL 60143 | KAISER FOUNDATION HEALTH PLAN OF COLORADO | $625 | — | $625 | 3.25% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 14TH FLOOR ITASCA, IL 60143 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $320 | — | $320 | 14.99% |
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 | 315 | 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) | 315 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 421 | $4.2M |
| Dental | DELTA DENTAL OF CALIFORNIA | 660 | $360K |
| Vision | VISION SERVICE PLAN | 298 | $58K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 315 | $245K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 315 | $245K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 315 | $245K |
| Prescription drug(3 contracts, 3 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 421 | $4.2M |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 315 | $247K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 660 | — |
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."
No prospect flags tripped on this filing.