| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 1900 WEST LOOP SOUTH, SUITE 1600 HOUSTON, TX 77027 | CIGNA HEALTHCARE OF CALIFORNIA | $43K | $0 | $43K | 1.85% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 18201 VON KARMAN AVENUE, SUITE 200 IRVINE, CA 92612 | CIGNA HEALTHCARE OF CALIFORNIA | $33K | $0 | $33K | 1.41% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 1900 WEST LOOP SOUTH, SUITE 1600 HOUSTON, TX 77027 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $24K | $0 | $24K | 3.20% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 18201 VON KARMAN AVENUE, SUITE 200 IRVINE, CA 92612 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $19K | $0 | $19K | 2.49% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD 6TH FLOOR GLENDALE, CA 91203 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $0 | $4K | $4K | 0.54% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $10K | $2K | $12K | 17.46% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD GLENDALE, CA 91203 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $2K | $0 | $2K | 10.82% |
| FLEXVISION3 | 15400 CALHOUN DRIVE ROCKVILLE, MD 20855 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $1K | $0 | $1K | 5.41% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD 6TH FLOOR GLENDALE, CA 91203 | LEGAL CLUB OF AMERICA | $624 | $0 | $624 | 22.40% |
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 | 359 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 362 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTHCARE OF CALIFORNIA | 409 | $3.1M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 409 | $750K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 246 | $23K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 359 | $67K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 359 | $67K |
| Prescription drug(2 contracts, 2 carriers) | CIGNA HEALTHCARE OF CALIFORNIA | 409 | $3.1M |
| Other(3 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 359 | $77K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 409 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.