| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD SUITE 600 GLENDALE, CA 91203 | KAISER FOUNDATION HEALTH PLAN INC | $36K | $0 | $36K | 2.88% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | KAISER FOUNDATION HEALTH PLAN INC | $0 | $3K | $3K | 0.27% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD SUITE 600 GLENDALE, CA 91203 | METROPOLITAN LIFE INSURANCE COMPANY | $10K | $41 | $10K | 11.27% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $1K | $1K | 1.62% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 1111 SUPERIOR AVENUE EAST SUITE 1601 CLEVELAND, OH 44114 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $12 | $12 | 0.01% |
| HOGAN INSURANCE SERVICES, INC.3 | PO BOX 7419 WESTLAKE VILLAGE, CA 91359 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 5.26% |
| MCCAREY INC3 Filed as: MCCAREY, INC. | 965 MESA DRIVE CAMARILLO, CA 93010 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $37 | $1K | 3.07% |
| GALLAGHER BENEFIT SERVICES, INC.3 | UNKNOWN WOODLAND HILLS, CA 91365 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $785 | $13 | $798 | 2.00% |
| ANDREA MARIE TIERCE3 | 2204 PLEASANTWOOD LANE ESCONDIDO, CA 92026 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $410 | $15 | $425 | 1.06% |
| MAGNONE FINANCIAL SERVICES CORP3 Filed as: MAGNONE FINANCIAL SERVICES CORP. | 3151 OUTRIGGER AVENUE VENTURA, CA 93001 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $413 | $0 | $413 | 1.03% |
| R&B ENROLL. SVCS. AND OTHER AGENTS3 | PO BOX 3216 CRESTLINE, CA 92325 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $98 | $0 | $98 | 0.25% |
| DEL DOWNEY3 | 32056 MERLOT CREST TEMECULA, CA 92591 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $96 | $0 | $96 | 0.24% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD SUITE 600 GLENDALE, CA 91203 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $2K | $0 | $2K | 9.92% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $0 | $286 | $286 | 1.53% |
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 | 101 | 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) | 101 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 183 | $1.2M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 337 | $104K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 337 | $86K |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 337 | $126K |
| Short-term disability | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 49 | $40K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 183 | $1.2M |
| Other(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 337 | $1.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 337 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.