| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 2850 GOLF ROAD 5TH FLOOR ROLLING MEADOWS, IL 60008 | BLUE CROSS OF CALIFORNIA | $23K | $6K | $29K | 1.76% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | P.O. BOX 3009 ARLINGTON HEIGHTS, IL 60006 | KAISER FOUNDATION HEALTH PLAN INC. | — | $634 | $634 | 0.10% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 2850 GOLF ROAD 5TH FLOOR ROLLING MEADOWS, IL 60008 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $2K | $664 | $3K | 1.76% |
| VARIOUS - SEE ATTACHED3 | C/O AFLAC 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $4K | $123 | $5K | 10.04% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 3655 NOBEL DRIVE, SUITE 450 SAN DIEGO, CA 92122 | METLIFE LEGAL PLANS | $843 | — | $843 | 10.06% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES OF CA | 505 N. BRAND BLVD., 6TH FLOOR GLENDALE, CA 91203 | METLIFE LEGAL PLANS | — | $121 | $121 | 1.44% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 5420 LYNDON B JOHNSON FWY STE 400 DALLAS, TX 75240 | METLIFE LEGAL PLANS | — | $37 | $37 | 0.44% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 WEST GOLF ROAD 5TH FLOOR ROLLING MEADOWS, IL 60008 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $22 | $22 | 1.73% |
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 | 268 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 269 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 193 | $2.3M |
| Dental | BLUE CROSS OF CALIFORNIA | 193 | $1.7M |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 268 | $176K |
| Life insurance(2 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 268 | $221K |
| Short-term disability | AFLAC | 41 | $45K |
| Long-term disability | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 268 | $176K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 193 | $2.3M |
| Other(4 contracts, 4 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 268 | $231K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 268 | — |
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."
No prospect flags tripped on this filing.