| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE ITASCA, IL 60143 | KAISER FOUNDATION HEALTH PLAN, INC. | $28K | $0 | $28K | 4.91% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE 14TH FLOOR ITASCA, IL 60143 | KAISER FOUNDATION HEALTH PLAN, INC. | $0 | $143 | $143 | 0.03% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 18201 VON KARMAN AVENUE SUITE 200 IRVINE, CA 92612 | UNITEDHEALTHCARE INSURANCE COMPANY | $19K | $0 | $19K | 4.57% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 18201 VON KARMAN AVENUE SUITE 200 IRVINE, CA 92612 | DELTA DENTAL OF CALIFORNIA | $9K | $0 | $9K | 10.00% |
| GALALGHER BENEFIT SERVICES, INC.3 | 18201 VON KARMAN AVENUE SUITE 200 IRVINE, CA 92612 | UNIMERICA LIFE INSURANCE SERVICES | $8K | $0 | $8K | 14.40% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD SUITE 1000 ROLLING MEADOWS, IL 60008 | VISION SERVICE PLAN | $950 | $0 | $950 | 6.08% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE 21ST FLOOR ITASCA, IL 60143 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $339 | $0 | $339 | 3.45% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD 11TH FLOOR ROLLING MEADOWS, IL 60008 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $2 | $2 | 0.02% |
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 | 94 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 99 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 122 | $977K |
| Dental | DELTA DENTAL OF CALIFORNIA | 130 | $89K |
| Vision | VISION SERVICE PLAN | 96 | $16K |
| Life insurance | UNIMERICA LIFE INSURANCE SERVICES | 105 | $56K |
| Short-term disability | UNIMERICA LIFE INSURANCE SERVICES | 105 | $56K |
| Long-term disability | UNIMERICA LIFE INSURANCE SERVICES | 105 | $56K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 122 | $977K |
| Other(3 contracts, 3 carriers) | UNIMERICA LIFE INSURANCE SERVICES | 105 | $70K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 130 | — |
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.