| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 505 N BRAND BLVD, 6TH FLOOR GLENDALE, CA 91203 | CALIFORNIA PHYSICIANS SERVICE | $9K | — | $9K | 3.47% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 505 N BRAND BLVD, 6TH FLOOR GLENDALE, CA 91203 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | $956 | $7K | 10.66% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MOUNTAIN STATES | PO BOX 5099 TWIN FALLS, ID 83303 | PACIFICSOURCE HEALTH PLANS | $576 | — | $576 | 2.19% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 505 N BRAND BLVD, 6TH FLOOR GLENDALE, CA 91203 | PRINCIPAL LIFE INSURANCE COMPANY | $1K | $291 | $1K | 9.37% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 505 N BRAND BLVD, 6TH FLOOR GLENDALE, CA 91203 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $712 | $121 | $833 | 11.70% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 505 N BRAND BLVD, 6TH FLOOR GLENDALE, CA 91203 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $591 | $100 | $691 | 11.69% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 505 N BRAND BLVD, 6TH FLOOR GLENDALE, CA 91203 | PRINCIPAL LIFE INSURANCE COMPANY | $362 | $105 | $467 | 8.86% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 505 N BRAND BLVD, 6TH FLOOR GLENDALE, CA 91203 | AMERITAS LIFE INSURANCE CORP. | $303 | $55 | $358 | 11.82% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 505 N BRAND BLVD, 6TH FLOOR GLENDALE, CA 91203 | SAFEGUARD HEALTH PLANS, INC. | $222 | $30 | $252 | 11.08% |
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 | 591 | 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) | 591 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 610 | $5.3M |
| Dental(3 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 610 | $4.6M |
| Vision | AMERITAS LIFE INSURANCE CORP. | 35 | $3K |
| Life insurance(2 contracts) | PRINCIPAL LIFE INSURANCE COMPANY | 62 | $20K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 26 | $6K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 26 | $7K |
| Prescription drug(4 contracts, 4 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 610 | $5.3M |
| Other(2 contracts) | PRINCIPAL LIFE INSURANCE COMPANY | 62 | $20K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 610 | — |
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."
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.