| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ARTHUR J. GALLAGHER & CO. | 4100 NEWPORT PLACE DRIVE NEWPORT BEACH, CA 92660 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $63K | — | $63K | 4.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ARTHUR J. GALLAGHER & CO. | 4100 NEWPORT PLACE DRIVE NEWPORT BEACH, CA 92660 | KAISER FOUNDATION HEALTH PLAN INC. | $24K | — | $24K | 4.97% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ARTHUR J. GALLAGHER & CO. | 4100 NEWPORT PLACE DRIVE NEWPORT BEACH, CA 92660 | GUARDIAN | $20K | $9K | $29K | 14.34% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ARTHUR J. GALLAGHER & CO. | 4100 NEWPORT PLACE DRIVE NEWPORT BEACH, CA 92660 | KAISER FOUNDATION HEALTH PLAN INC. | $7K | — | $7K | 4.97% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ARTHUR J. GALLAGHER & CO. | 4100 NEWPORT PLACE DRIVE NEWPORT BEACH, CA 92660 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $9K | $602 | $9K | 16.02% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ARTHUR J. GALLAGHER & CO. | 4100 NEWPORT PLACE DRIVE NEWPORT BEACH, CA 92660 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $6K | $525 | $6K | 16.34% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ARTHUR J. GALLAGHER & CO. | 4100 NEWPORT PLACE DRIVE NEWPORT BEACH, CA 92660 | VISION SERVICE PLAN | $3K | — | $3K | 8.44% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ARTHUR J. GALLAGHER & CO. | 4100 NEWPORT PLACE DRIVE NEWPORT BEACH, CA 92660 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $183 | $2K | 16.32% |
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 | 300 | 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) | 302 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 178 | $2.2M |
| Dental | GUARDIAN | 300 | $199K |
| Vision | VISION SERVICE PLAN | 179 | $30K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 236 | $59K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 240 | $14K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 240 | $39K |
| Prescription drug(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC. | 133 | $623K |
| Other | RELIANCE STANDARD LIFE INSURANCE COMPANY | 236 | $59K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 300 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.