| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| 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 | — | $1K | $1K | 0.08% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 18201 VON KARMAN AVE STE 1020 IRVINE, CA 92612 | KAISER FOUNDATION HEALTH PLAN INC | — | $56 | $56 | 0.00% |
| PCF INSURANCE SERVICES OF THE WEST3 | 21300 VICTORY BLVD STE 700 WOODLAND HILLS, CA 91367 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $2K | $2K | 2.71% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 18201 VON KARMAN AVE STE 200 IRVINE, CA 92612 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $107 | $107 | 0.14% |
| PCF INSURANCE SERVICES OF THE WEST3 | 21300 VICTORY BLVD STE 700 WOODLAND HILLS, CA 91367 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $1K | $1K | 3.64% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 18201 VON KARMAN AVE STE 200 IRVINE, CA 92612 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $50 | $50 | 0.14% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 333 EAST OSBORN ROAD, SUITE 270 PHOENIX, AZ 85012 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $6K | $1K | $7K | 25.75% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF ROAD 5TH FLOOR ROLLING MEADOWS, IL 60008 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | -$437 | — | -$437 | -1.52% |
| PCF INSURANCE SERVICES OF THE WEST3 | 21300 VICTORY BLVD STE 700 WOODLAND HILLS, CA 91367 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $199 | $199 | 2.10% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 18201 VON KARMAN AVE STE 200 IRVINE, CA 92612 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $10 | $10 | 0.11% |
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 | 202 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 203 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 197 | $3.0M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 192 | $1.7M |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO | 332 | $20K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 197 | $75K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 187 | $36K |
| Prescription drug(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 197 | $3.0M |
| Other(4 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 202 | $114K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 332 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.