| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 100 SMITH RANCH ROAD, SUITE 112 SAN RAFAEL, CA 94903 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $80K | $0 | $80K | 10.50% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 6300 SOUTH SYRACUSE WAY, SUITE 700 CENTENNIAL, CO 80111 | KAISER FOUNDATION HEALTH PLAN OF COLORADO | $8K | $0 | $8K | 2.95% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | KAISER FOUNDATION HEALTH PLAN INC | $9K | $0 | $9K | 5.03% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 160 WEST SANTA CLARA STREET SUITE 300 SAN JOSE, CA 95113 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $16K | $0 | $16K | 9.93% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $10K | $753 | $10K | 11.10% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 6300 SOUTH SYRACUSE WAY, SUITE 700 CENTENNIAL, CO 80111 | HARTFORD LIFE AND ACCIDENT | $2K | $0 | $2K | 19.50% |
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 | 137 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 15 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 152 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 195 | $1.2M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 144 | $165K |
| Vision | VISION SERVICE PLAN | 137 | $18K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 137 | $95K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 137 | $95K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 137 | $95K |
| Prescription drug(3 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 195 | $1.2M |
| Other(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 137 | $106K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 195 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.