| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE ITASCA, IL 60143 | CIGNA HEALTHCARE OF CALIFORNIA | $64K | — | $64K | 1.80% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE ITASCA, IL 60143 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $67K | — | $67K | 2.41% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD 6TH FLOOR GLENDALE, CA 91203 | KAISER FOUNDATION HEALTH PLAN INC | $23K | — | $23K | 1.29% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 14TH FLOOR ITASCA, IL 60143 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $50K | — | $50K | 9.14% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE ITASCA, IL 60143 | VISION SERVICE PLAN | $12K | — | $12K | 10.00% |
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 | 991 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 15 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 69 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,075 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | CIGNA HEALTHCARE OF CALIFORNIA | 1,496 | $8.1M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,496 | $2.8M |
| Vision | VISION SERVICE PLAN | 879 | $117K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 991 | $550K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 991 | $550K |
| Prescription drug(3 contracts, 3 carriers) | CIGNA HEALTHCARE OF CALIFORNIA | 1,496 | $8.1M |
| Other(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 991 | $562K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,496 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.