| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | KAISER FOUNDATION HEALTH PLAN INC | $25K | $0 | $25K | 2.51% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD GLENDALE, CA 91203 | EYEMED | $3K | $0 | $3K | 9.92% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $3K | $306 | $3K | 11.06% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $349 | $2K | 7.68% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 1111 SUPERIOR AVE E STE 1601 CLEVELAND, OH 44114 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $8 | $8 | 0.03% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | $95 | $1K | 10.81% |
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 | 206 | 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) | 206 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 185 | $983K |
| Dental(2 contracts, 2 carriers) | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | 172 | $53K |
| Vision | EYEMED | 231 | $27K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 213 | $12K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 185 | $983K |
| Other | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 213 | $12K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 231 | — |
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.