| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 3655 NOBEL DRIVE, SUITE 450 SAN DIEGO, CA 92122 | CALIFORNIA PHYSICIANS SERVICE | — | $86K | $86K | 5.36% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 500 N BRAND BLVD, SUITE 100 GLENDALE, CA 91203 | KAISER FOUNDATION HEALTH PLAN, INC. | $33K | — | $33K | 4.39% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 3655 NOBEL DRIVE, SUITE 450 SAN DIEGO, CA 92122 | UNITED CONCORDIA INSURANCE COMPANY | $30K | — | $30K | 7.57% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 235 HIGHLANDIA DRIVE STE 200 BATON ROUGE, LA 70810 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $14K | — | $14K | 15.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | ONE COMMERCE SQUARE STE 820 2005 MARKET STREET PHILADELPHIA, PA 19103 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $1K | $1K | 1.12% |
| COMPSYCH3 | 455 NORTH CITYFRONT PLAZA DRIVE 13TH FLOOR CHICAGO, IL 60611 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $936 | $936 | 1.03% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $24 | $24 | 0.03% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 3655 NOBEL DRIVE, SUITE 450 SAN DIEGO, CA 92122 | UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. | $3K | — | $3K | 7.39% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 3655 NOBEL DRIVE, SUITE 450 SAN DIEGO, CA 92122 | VISION SERVICE PLAN | $1K | — | $1K | 8.00% |
| VARIOUS - SEE ATTACHED3 Filed as: AFLAC - SEE ATTACHMENT | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $321 | — | $321 | 10.95% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER INSURANCE | 3655 NOBEL DRIVE SUITE 450 SAN DIEGO, CA 92122 | HEALTH AND HUMAN RESOURCE CENTER, INC. | $160 | — | $160 | 6.65% |
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 | 161 | 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) | 161 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 149 | $2.3M |
| Dental(2 contracts, 2 carriers) | UNITED CONCORDIA INSURANCE COMPANY | 350 | $437K |
| Vision | VISION SERVICE PLAN | 106 | $13K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 155 | $91K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 155 | $91K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 155 | $91K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 149 | $2.3M |
| Other(4 contracts, 4 carriers) | CALIFORNIA PHYSICIANS SERVICE | 162 | $1.7M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 350 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.