| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 500 N BRAND BLVD STE 100 GLENDALE, CA 91203 | KAISER FOUNDATION HEALTH PLAN INC | $70K | $0 | $70K | 4.94% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC - | 323 WEST LAKESIDE AVENUE STE 410 CLEVELAND, OH 44113 | STANDARD INSURANCE COMPANY | $18K | $6K | $25K | 20.05% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | — | DELTA DENTAL OF CALIFORNIA | $5K | $0 | $5K | 5.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | PO BOX 95287 CHICAGO, IL 60694 | VISION SERVICE PLAN | $1K | $0 | $1K | 5.45% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC. DBA VA | 1950 W CORPORATE WAY ANAHEIM, CA 92801 | VISION SERVICE PLAN | $36 | $0 | $36 | 0.13% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | — | DELTA DENTAL OF CALIFORNIA | $3K | $0 | $3K | 9.96% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC - | 323 WEST LAKESIDE AVENUE STE 410 CLEVELAND, OH 44113 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $5K | $897 | $6K | 23.29% |
| THE BENEFIT COMPANY INC4 Filed as: BENEFIT SERVICES INC | 2850 GOLF ROAD STE 1000 ROLLING MEADOWS, IL 60008 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $2K | $0 | $2K | 21.00% |
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 | 186 | 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) | 186 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 222 | $1.4M |
| Dental(2 contracts) | DELTA DENTAL OF CALIFORNIA | 185 | $124K |
| Vision | VISION SERVICE PLAN | 145 | $27K |
| Life insurance(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 290 | $148K |
| Short-term disability(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 290 | $148K |
| Long-term disability(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 290 | $148K |
| Other | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | 46 | $7K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 290 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.