| 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 | $34K | $0 | $34K | 2.89% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | KAISER FOUNDATION HEALTH PLAN INC | $0 | $773 | $773 | 0.07% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD SUITE 600 GLENDALE, CA 91203 | METROPOLITAN LIFE INSURANCE COMPANY | $9K | $54 | $9K | 9.31% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $1K | $1K | 1.51% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60694 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $4 | $4 | 0.00% |
| HOGAN INSURANCE SERVICES, INC.3 Filed as: HOGAN INSURANCE SERVICES INC. | PO BOX 7419 WESTLAKE VILLAGE, CA 91359 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 5.23% |
| MCCAREY INC3 Filed as: MCCAREY INC. | 6320 GREENHAVEN DRIVE CARLSBAD, CA 92009 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $868 | $2 | $870 | 2.56% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 5550 TOPANGA CANYON BOULEVARD SUITE 310 WOODLAND HILLS, CA 91367 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $469 | $1 | $470 | 1.38% |
| ANDREA MARIE TIERCE3 | 2204 PLEASANTWOOD LANE ESCONDIDO, CA 92026 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $303 | $1 | $304 | 0.90% |
| MAGNONE FINANCIAL SERVICES CORP3 Filed as: MAGNONE FINANCIAL SERVICES CORP. | 3151 OUTRIGGER AVENUE VENTURA, CA 93001 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $297 | $0 | $297 | 0.87% |
| DEL DOWNEY3 | 32056 MERLOT CREST TEMECULA, CA 92591 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $80 | $0 | $80 | 0.24% |
| R & B ENROLLMENT SERVICES INC3 Filed as: R AND B ENROLLMENT SERVICES INC. | PO BOX 3216 CRESTLINE, CA 92325 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $49 | $0 | $49 | 0.14% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD SUITE 600 GLENDALE, CA 91203 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $2K | $0 | $2K | 9.58% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $0 | $281 | $281 | 1.66% |
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 | 125 | 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) | 125 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 156 | $1.2M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 293 | $116K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 293 | $99K |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 293 | $133K |
| Short-term disability | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 41 | $34K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 156 | $1.2M |
| Other(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 293 | $1.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 293 | — |
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.