| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | DEPT 133667 PO BOX 3900 SAN FRANCISCO, CA 94139 | AETNA HEALTH, INC. | $52K | $0 | $52K | 3.21% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SERVICES OF NEW YOR | 5000 BIRCH ST #215 NEWPORT BEACH, CA 92660 | AETNA HEALTH, INC. | $0 | $67 | $67 | 0.00% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | DEPT 133667 PO BOX 3900 SAN FRANCISCO, CA 94139 | AETNA LIFE INSURANCE COMPANY | $12K | $7K | $20K | 6.31% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | 959 SKYWAY ROAD 2ND FLOOR SAN CARLOS, CA 94070 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $6K | $2K | $8K | 8.59% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SERVICES | 10 SOUTH WACKER DR FLOOR 17 CHICAGO, IL 60606 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $3K | $0 | $3K | 3.39% |
| AMWINS3 Filed as: AMWINS GROUP BFTS INC | 50 WHITECAP DR NORTH KINGSTOWN, RI 02852 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $10K | $0 | $10K | 17.76% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SVCS USA INC | 21250 HAWTHORNE BLVD STE 600 TORRANCE, CA 90503 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $5K | $0 | $5K | 8.19% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 21250 HAWTHORNE BLVD. SUITE 600 TORRANCE, CA 90503 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $2K | — | $2K | 9.09% |
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 | 253 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 254 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | AETNA HEALTH, INC. | 437 | $2.0M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 215 | $96K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 275 | $18K |
| Life insurance | AETNA LIFE INSURANCE COMPANY | 233 | $314K |
| Other(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 242 | $371K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 437 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.