| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 500 NORTH SANTA FE VISALIA, CA 93292 | CALIFORNIA PHYSICIANS' SERVICE | $0 | $113K | $113K | 2.81% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $8K | $2K | $10K | 6.23% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $13K | $2K | $15K | 11.87% |
| UNITED FINANCIAL SERVICS INC3 | 100 LIGHT ST. MS B-3447 BALTIMORE, MD 21202 | TRANSAMERICA LIFE INSURANCE COMPANY | $25K | $0 | $25K | 39.21% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, INC | 505 NORTH BRAND BOULEVARD 6TH FLOOR GLENDALE, CA 912033944 | TRANSAMERICA LIFE INSURANCE COMPANY | $9K | $0 | $9K | 13.96% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ARTHUR J. GALLAGHER & CO. INSURANCE | 505 NORTH BRAND BOULEVARD SUITE 600 GLENDALE, CA 91203 | NATIONAL UNION FIRE INS. CO. OF PITTSBURGH, PA | $278 | $0 | $278 | 14.99% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 500 NORTH SANTA FE VISALIA, CA 93292 | BLUE SHIELD OF CALIFORNIA LIFE HEALTH INSURANCE COMPANY | -$1 | $0 | -$1 | — |
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 | 283 | 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) | 283 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA PHYSICIANS' SERVICE | 589 | $4.0M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 240 | $154K |
| Vision | GERBER | 243 | $34K |
| Life insurance(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 288 | $127K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 288 | $127K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 288 | $127K |
| Prescription drug | CALIFORNIA PHYSICIANS' SERVICE | 589 | $4.0M |
| Other(4 contracts, 4 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 288 | $192K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 589 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.