| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | PO BOX 3900 SAN FRANCISCO, CA 94139 | AETNA HEALTH, INC. | $59K | $0 | $59K | 3.47% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SVCS., INC. | PO BOX 3900 SAN FRANCISCO, CA 94139 | AETNA LIFE INSURANCE COMPANY AND AFFILIATES | $14K | $9K | $24K | 7.17% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 10 SOUTH WACKER DRIVE, 17TH FLOOR CHICAGO, IL 60606 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $9K | $0 | $9K | 10.00% |
| AMWINS3 Filed as: AMWINS GROUP BENEFITS, INC. | 50 WHITECAP DRIVE NORTH KINGSTOWN, RI 02852 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $5K | $0 | $5K | 7.26% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 21250 HAWTHORNE BOULEVARD SUITE 600 TORRANCE, CA 90503 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $4K | $0 | $4K | 5.52% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 21250 HAWTHORNE BLVD, SUITE 600 TORRANCE, CA 90503 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | $0 | $2K | 3.39% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 21250 HAWTHORNE BLVD, SUITE 600 TORRANCE, CA 90503 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $2K | $0 | $2K | 9.10% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 21250 HAWTHORNE BLVD, SUITE 600 TORRANCE, CA 90503 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $162 | $0 | $162 | 0.77% |
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 | 267 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 269 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA HEALTH, INC. | 445 | $2.0M |
| Dental | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 211 | $94K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 351 | $21K |
| Life insurance | AETNA LIFE INSURANCE COMPANY AND AFFILIATES | 260 | $331K |
| Prescription drug(2 contracts, 2 carriers) | AETNA HEALTH, INC. | 445 | $2.0M |
| Other(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY AND AFFILIATES | 260 | $404K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 445 | — |
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.