| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 500 NORTH SANTA FE VISALIA, CA 93292 | CALIFORNIA PHYSICIANS SERVICE | $0 | $48K | $48K | 4.17% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | KAISER FOUNDATION HEALTH PLAN INC | $35K | $0 | $35K | 4.05% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 18201 VON KARMAN AVENUE, SUITE 200 IRVINE, CA 92612 | DELTA DENTAL OF CALIFORNIA | $10K | $0 | $10K | 8.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $0 | $6K | 9.51% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $1K | $1K | 1.98% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER H&B ADMIN, LLC | PO BOX 850502 MINNEAPOLIS, MN 55485 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | $157 | $2K | 9.98% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 6967 SOUTH RIVER GATE DRIVE SUITE 200 MIDVALE, UT 84047 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | $0 | $2K | 7.44% |
| ANN MARIE LIOTTA3 | THREE SAMANTHA COURT SEWELL, NJ 08080 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $33 | $2K | 21.78% |
| M FINANCIAL HOLDINGS INC3 Filed as: M. FINANCIAL HOLDINGS, INC. | 1125 NW COUCH STREET, SUITE 900 PORTLAND, OR 97209 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $429 | $429 | 3.82% |
| INTEGRITY ASSET SERVICES LLC4 Filed as: INTEGRITY ASSET SERVICES, LLC | 1873 KOYUKON DRIVE SOUTH LAKE TAHOE, CA 96150 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $515 | $0 | $515 | 9.66% |
| GALLAGHER BENEFIT SERVICES, INC.4 | 18201 VON KARMAN AVENUE, SUITE 200 IRVINE, CA 92612 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $79 | $0 | $79 | 1.48% |
| IBRAHIM ABDELHADI4 | 3910 HART LANE, APARTMENT 601 AUSTIN, TX 78731 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $57 | $0 | $57 | 1.07% |
| ANGEL L. STEPHENS4 | 7207 SOMERSET POND DRIVE RUSKIN, FL 33573 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $36 | $0 | $36 | 0.67% |
| DAVID PAPERNO4 | 78347 GRAPE ARBOR AVENUE PALM DESERT, CA 92211 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $32 | $0 | $32 | 0.60% |
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 | 227 | 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) | 227 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 123 | $2.0M |
| Dental | DELTA DENTAL OF CALIFORNIA | 223 | $127K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 227 | $62K |
| Long-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 227 | $73K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 123 | $2.0M |
| Other(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 227 | $88K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 227 | — |
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.