| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 500 NORTH BRAND BOULEVARD SUITE 100 GLENDALE, CA 91203 | KAISER FOUNDATION HEALTH PLAN, INC. | $32K | $0 | $32K | 2.88% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 323 WEST LAKESIDE AVENUE, SUITE 410 CLEVELAND, OH 44113 | PRINCIPAL LIFE INSURANCE COMPANY | $12K | $0 | $12K | 9.94% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | PRINCIPAL LIFE INSURANCE COMPANY | $6K | $0 | $6K | 4.97% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | PRINCIPAL LIFE INSURANCE COMPANY | $0 | $3K | $3K | 2.94% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 4350 WEST CYPRESS STREET, SUITE 300 TAMPA, FL 33607 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $0 | $1K | 5.04% |
| MCCAREY INC3 Filed as: MCCAREY, INC. | 6320 GREENHAVEN DRIVE CARLSBAD, CA 92009 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $604 | $0 | $604 | 2.55% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 21820 BURBANK BOULEVARD, SUITE 175 WOODLAND HILLS, CA 91367 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $298 | $0 | $298 | 1.26% |
| MAGNONE FINANCIAL SERVICES CORP3 Filed as: MAGNONE FINANCIAL SERVICES CORP. | 3151 OUTRIGGER AVENUE VENTURA, CA 93001 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $219 | $0 | $219 | 0.92% |
| ANDREA MARIE TIERCE3 | 1199 MADRONE LANE PLACERVILLE, CA 95667 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $209 | $0 | $209 | 0.88% |
| DEL DOWNEY3 | 32056 MERLOT CREST TEMECULA, CA 92591 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $50 | $0 | $50 | 0.21% |
| 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 | $31 | $0 | $31 | 0.13% |
| UNKNOWN3 | UNKNOWN VENTURA, CA 93003 | HOLMAN PROFESSIONAL COUNSELING CENTERS | $206 | $0 | $206 | 5.01% |
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 | 199 | 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) | 199 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN, INC. | 137 | $1.1M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 261 | $116K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 261 | $116K |
| Life insurance(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 261 | $140K |
| Long-term disability | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 31 | $24K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN, INC. | 137 | $1.1M |
| Other(4 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 261 | $1.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 261 | — |
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.