| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 333 EAST OSBORN ROAD, SUITE 270 PHOENIX, AZ 85012 | AETNA HEALTH OF CALIFORNIA, INC. | $41K | $0 | $41K | 3.19% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 333 EAST OSBORN ROAD, SUITE 270 PHOENIX, AZ 85012 | AETNA LIFE INSURANCE COMPANY | $35K | $0 | $35K | 4.04% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD SUITE 600 GLENDALE, CA 91203 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $17K | $1K | $18K | 12.02% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | $0 | $8K | 15.00% |
| GIS NATIONAL3 | 9500 KOGER AVENUE, SUITE 200 SAINT PETERSBURG, FL 33702 | METLIFE LEGAL PLANS | $1K | $0 | $1K | 11.74% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 18201 VON KARMAN AVENUE, SUITE 200 IRVINE, CA 92612 | METLIFE LEGAL PLANS | $971 | $0 | $971 | 10.00% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 | PO BOX 9201 AUSTIN, TX 78766 | METLIFE LEGAL PLANS | $0 | $488 | $488 | 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 | 248 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 8 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 256 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA HEALTH OF CALIFORNIA, INC. | 397 | $2.1M |
| Dental | AETNA LIFE INSURANCE COMPANY | 397 | $871K |
| Vision | RELIANCE STANDARD LIFE INSURANCE COMPANY | 447 | $149K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 447 | $149K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 447 | $149K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 447 | $149K |
| Prescription drug(2 contracts, 2 carriers) | AETNA HEALTH OF CALIFORNIA, INC. | 397 | $2.1M |
| Other(3 contracts, 3 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 447 | $213K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 447 | — |
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.