| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 45 E. RIVER PARK PLANCE W SUITE 605 FRESNO, CA 93720 | BLUE SHIELD OF CALIFORNIA | $4K | $545 | $4K | 0.57% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2 PIERCE PLAN THE GALLAGHER CENTRE ITASCA, IL 601431203 | KAISER FOUNDATION HEALTH PLAN INC. | $34K | $988 | $35K | 5.34% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 45 E. RIVER PARK PLACE W SUITE 408 FRESNO, CA 93720 | THE GUARDIAN LIFE INSURANCE COMPANY | $11K | $1K | $13K | 10.06% |
| MARK S METTILLE3 Filed as: MARK S. METTILLE | 107 CANDLELIGHT LANE MORRIS, IL 60450 | THE GUARDIAN LIFE INSURANCE COMPANY | $6K | — | $6K | 5.03% |
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 | 160 | 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) | 160 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE SHIELD OF CALIFORNIA | 154 | $1.4M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY | 160 | $127K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY | 160 | $127K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY | 160 | $127K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY | 160 | $127K |
| Prescription drug | BLUE SHIELD OF CALIFORNIA | 104 | $788K |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY | 160 | $127K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 160 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.