| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | PO BOX 39000 SAN FRANCISCO, CA 94139 | AETNA HEALTH, INC. | $50K | $0 | $50K | 3.05% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 39000 SAN FRANCISCO, CA 94139 | AETNA HEALTH, INC. | $24K | $0 | $24K | 1.46% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 600 HIGHWAY 169 SOUTH, 12TH FLOOR SAINT LOUIS PARK, MN 55426 | KAISER FOUNDATION HEALTH PLAN INC | $59K | $0 | $59K | 3.99% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | PO BOX 39000 SAN FRANCISCO, CA 94139 | AETNA LIFE INSURANCE COMPANY | $28K | $6K | $34K | 5.16% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 39000 SAN FRANCISCO, CA 94139 | AETNA LIFE INSURANCE COMPANY | $14K | $0 | $14K | 2.08% |
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 | 237 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 38 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 9 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 284 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | AETNA HEALTH, INC. | 576 | $3.8M |
| Dental | AETNA LIFE INSURANCE COMPANY | 576 | $653K |
| Vision | AETNA LIFE INSURANCE COMPANY | 576 | $653K |
| Life insurance | AETNA LIFE INSURANCE COMPANY | 576 | $653K |
| Prescription drug(3 contracts, 3 carriers) | AETNA HEALTH, INC. | 576 | $3.8M |
| Other | AETNA LIFE INSURANCE COMPANY | 576 | $653K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 576 | — |
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.