| 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 | $131K | $0 | $131K | 4.66% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 500 N SANTA FE VISALIA, CA 93292 | BLUE SHIELD OF CALIFORNIA | $0 | $68K | $68K | 3.09% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | GBS FINANCE PHOENIX, AZ 85012 | AETNA LIFE INSURANCE COMPANY | $16K | $0 | $16K | 4.98% |
| GALLAGHER BENEFIT SERVICES, INC.3 | NATIONAL INCENTIVE 505 NORTH BRAND BLVD SUITE 100 GLENDALE, CA 91203 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $24K | $0 | $24K | 14.84% |
| FMLASOURCE INC5 | 455 N CITYFRONT PLAZA DRIVE 13TH FLOOR CHICAGO, IL 60611 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $6K | $6K | 3.45% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 736 S STONE AVE LA GRANGE, IL 60525 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $5K | $5K | 3.11% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BLVD GLENDALE, CA 91203 | EYEMED VISION CARE | $5K | $0 | $5K | 9.93% |
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 | 550 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 554 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 381 | $5.0M |
| Dental | AETNA LIFE INSURANCE COMPANY | 743 | $312K |
| Vision | EYEMED VISION CARE | 700 | $45K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 585 | $160K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 585 | $160K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 585 | $160K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 381 | $5.0M |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 585 | $170K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 743 | — |
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."
No prospect flags tripped on this filing.