| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 10505 SORRENTO VALLEY RD, SUITE 200 SAN DIEGO, CA 92121 | BLUE CROSS OF CALIFORNIA | $9K | $1K | $10K | 0.61% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ARTHUR J. GALLAGHER | P.O. BOX 3009 ARLINGTON HEIGHTS, IL 60006 | KAISER FOUNDATION HEALTH PLAN INC. | — | $2K | $2K | 0.36% |
| GALLAGHER BENEFIT SERVICES, INC.3 | P.O. BOX 3009 ARLINGTON HEIGHTS, IL 60006 | KAISER FOUNDATION HEALTH PLAN INC. | — | $91 | $91 | 0.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 10505 SORRENTO VALLEY RD, SUITE 200 SAN DIEGO, CA 92121 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $7K | $1K | $8K | 11.56% |
| VARIOUS - SEE ATTACHED3 | C/O AFLAC 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $5K | — | $5K | 18.42% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 10505 SORRENTO VALLEY RD., STE. 200 SAN DIEGO, CA 92121 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $103 | $16 | $119 | 0.61% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 10505 SORRENTO VALLEY RD, SUITE 200 SAN DIEGO, CA 92121 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $980 | $38 | $1K | 10.39% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 10505 SORRENTO VALLEY RD, SUITE 200 SAN DIEGO, CA 92121 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | $143 | $1K | 14.66% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 10505 SORRENTO VALLEY RD, SUITE 200 SAN DIEGO, CA 92121 | HYATT LEGAL PLANS | $1K | $160 | $1K | 17.51% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 10505 SORRENTO VALLEY RD, SUITE 200 SAN DIEGO, CA 92121 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $168 | $14 | $182 | 16.25% |
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 | 313 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | 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)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 206 | $2.3M |
| Dental | BLUE CROSS OF CALIFORNIA | 206 | $1.6M |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 148 | $20K |
| Life insurance(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 313 | $97K |
| Short-term disability | AFLAC | 62 | $28K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 313 | $10K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 206 | $2.3M |
| Other(4 contracts, 3 carriers) | AFLAC | 313 | $46K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 313 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.