| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | KAISER FOUNDATION HEALTH PLAN INC | $107K | $0 | $107K | 4.10% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 500 N SANTA FE VISALIA, CA 93292 | BLUE SHIELD OF CALIFORNIA | $0 | $59K | $59K | 3.10% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | GBS FINANCE PHOENIX, AZ 85012 | AETNA LIFE INSURANCE COMPANY | $10K | $0 | $10K | 3.32% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | GBS FINANCE ARLINGTON HTS, IL 60006 | AETNA LIFE INSURANCE COMPANY | $5K | $0 | $5K | 1.66% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BLVD SUITE 100 GLENDALE, CA 91203 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $19K | $0 | $19K | 14.82% |
| FMLASOURCE INC3 | 455 N CITYFRONT PLAZA DRIVE 13TH FLOOR CHICAGO, IL 60611 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $8K | $8K | 6.63% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 2850 GOLF ROAD 5TH FL ROLLING MEADOW, IL 60008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $4K | $4K | 3.02% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BLVD GLENDALE, CA 91203 | EYEMED VISION CARE | $5K | $0 | $5K | 10.70% |
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 | 458 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 460 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 369 | $4.5M |
| Dental | AETNA LIFE INSURANCE COMPANY | 674 | $302K |
| Vision | EYEMED VISION CARE | 638 | $45K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 514 | $125K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 514 | $125K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 514 | $125K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 369 | $4.5M |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 514 | $125K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 674 | — |
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.