| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERV USA | 10940 WHITE ROCK ROAD 2ND FLR RANCHO CORDOVA, CA 95670 | CALIFORNIA PHYSICIANS' SERVICE | $41K | $740 | $41K | 4.07% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSRUANCE SERVICES USA | 600 HIGHWAY 169 S 12TH FL SAINT LOUIS PARK, MN 55426 | KAISER FOUNDATION HEALTH PLAN INC. | $10K | — | $10K | 4.41% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVCICES USA | 21250 HAWTHORNE BLVD SUITE 600 TORRANCE, CA 90503 | DELTA DENTAL OF CALIFORNIA | $3K | — | $3K | 3.38% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SVCS USA INC | 21250 HAWTHORNE BLVD STE 600 TORRANCE, CA 90503 | HARTFORD LIFE AND ACCIDENT | $2K | — | $2K | 9.31% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SVCS USA INC | 10 SOUTH WACKER DRIVE FLOOR 17 CHICAGO, IL 60606 | HARTFORD LIFE AND ACCIDENT | — | $880 | $880 | 3.99% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | PO BOX 39000 SAN FRANCISCO, CA 94139 | VISION SERVICE PLAN | $1K | — | $1K | 5.54% |
| WELLS FARGO INSURANCE SERVICES3 | 21250 HAWTHORNE BLVD STE 600 TORRANCE, CA 90503 | MANAGED HEALTH NETWORK | $176 | — | $176 | 4.99% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SVCS USA INC | 21250 HAWTHORNE BLVD STE 600 TORRANCE, CA 90503 | HARTFORD LIFE AND ACCIDENT | $32 | — | $32 | 10.06% |
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 | 108 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 109 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA PHYSICIANS' SERVICE | 162 | $1.0M |
| Dental | DELTA DENTAL OF CALIFORNIA | 200 | $78K |
| Vision | VISION SERVICE PLAN | 103 | $20K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 117 | $22K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 117 | $22K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 162 | $1.2M |
| Other(3 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 117 | $26K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 200 | — |
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.