| 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 | $75K | $5K | $79K | 4.25% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ARTHUR J. GALLAGHER & CO. | 4100 NEWPORT PLACE DRIVE NEWPORT BEACH, CA 92660 | KAISER FOUNDATION HEALTH PLAN INC. | $21K | — | $21K | 5.46% |
| 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 | 5.47% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ARTHUR J. GALLAGHER & CO. | 4100 NEWPORT PLACE DRIVE NEWPORT BEACH, CA 92660 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $11K | $708 | $11K | 16.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ARTHUR J. GALLAGHER & CO. | 4100 NEWPORT PLACE DRIVE NEWPORT BEACH, CA 92660 | GUARDIAN | $18K | $7K | $25K | 42.87% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ARTHUR J. GALLAGHER & CO. | 4100 NEWPORT PLACE DRIVE NEWPORT BEACH, CA 92660 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $7K | $455 | $7K | 16.02% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ARTHUR J. GALLAGHER & CO. | 4100 NEWPORT PLACE DRIVE NEWPORT BEACH, CA 92660 | VISION SERVICE PLAN | $3K | — | $3K | 10.00% |
| 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 | $161 | $3K | 16.02% |
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 | 319 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 320 | 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 | 193 | $2.4M |
| Dental | GUARDIAN | 319 | $58K |
| Vision | VISION SERVICE PLAN | 180 | $33K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 310 | $70K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 318 | $16K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 318 | $45K |
| Prescription drug(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC. | 122 | $514K |
| Other | RELIANCE STANDARD LIFE INSURANCE COMPANY | 310 | $70K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 319 | — |
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.