| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, INC | 505 NORTH BRAND BLVD GLENDALE, CA 91203 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $93K | $0 | $93K | 12.86% |
| GARY WOOD ASSOCIATES, INC.3 | 1180 AVENUE OF THE AMERICAS 8TH FL NEW YORK, NY 10036 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $18K | $0 | $18K | 2.52% |
| W INSURANCE SERVICES INC3 Filed as: W INSURANCE SERVICES, INC. | 3035 CALLE FRONTERA SAN CLEMENTE, CA 92673 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | -$51K | $0 | -$51K | -7.10% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HIEGHTS, IL 600063009 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | $2K | $8K | 5.23% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE | PO BOX 3009 21ST FL ARLINGTON HEIGHTS, IL 60006 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $7K | $469 | $8K | 8.81% |
| GARY WOOD ASSOCIATES, INC.3 | 1180 AVENUE OF THE AMERICAS 8TH FL NEW YORK, NY 10036 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $0 | $2K | 1.71% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE | PO BOX 3009 21ST FL ARLINGTON HEIGHTS, IL 60006 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $135 | $3K | 9.03% |
| GARY WOOD ASSOCIATES, INC.3 | 1180 AVENUE OF THE AMERICAS 8TH FL NEW YORK, NY 10036 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $415 | $0 | $415 | 1.44% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE | PO BOX 3009 21ST FL ARLINGTON HEIGHTS, IL 60006 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $149 | $3K | 10.96% |
| GARY WOOD ASSOCIATES, INC.3 | 1180 AVENUE OF THE AMERICAS 8TH FL NEW YORK, NY 10036 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $392 | $0 | $392 | 1.62% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 505 NORTH BRAND BLVD GLENDALE, CA 91203 | EYEMED | $2K | $0 | $2K | 8.17% |
| GARY WOOD ASSOCIATES, INC.3 | 1180 AVENUE OF THE AMERICAS 8TH FL NEW YORK, NY 10036 | EYEMED | $214 | $0 | $214 | 0.90% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 600063009 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $237 | $60 | $297 | 5.16% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE | PO BOX 3009 21ST FL ARLINGTON HEIGHTS, IL 60006 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $455 | $36 | $491 | 8.68% |
| GARY WOOD ASSOCIATES, INC.3 | 1180 AVENUE OF THE AMERICAS 8TH FL NEW YORK, NY 10036 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $110 | $0 | $110 | 1.94% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO. EIN 59-1031071 NONE | Claims processing; Contract Administrator; Float revenue; Non-monetary compensation; Named fiduciary; Participant communication; Direct payment from the plan; Other services Service code 12 | — | $13K |
| THE ADVANTAGE GROUP NONE | Claims processing; Contract Administrator Service code 12 | 43471 RIDGE PARK DRIVE SUITE B TEMECULA, CA 92590 | $13K |
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 | 364 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 364 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 466 | $724K |
| Dental(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 446 | $157K |
| Vision | EYEMED | 435 | $24K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 409 | $89K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 56 | $24K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 101 | $29K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 466 | $724K |
| Other(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 409 | $95K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 466 | — |
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.