| 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 | $69K | — | $69K | 3.98% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ARTHUR J. GALLAGHER & CO. | 505 NORTH BRAND BLVD., SUITE 600 GLENDALE, CA 91203 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $3K | $3K | 0.17% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ARTHUR J. GALLAGHER & CO. | 4100 NEWPORT PLACE DRIVE, SUITE 650 NEWPORT BEACH, CA 92660 | KAISER FOUNDATION HEALTH PLAN INC. | $12K | — | $12K | 4.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ARTHUR J. GALLAGHER & CO. | P.O. BOX 3009 ARLINGTON HEIGHTS, IL 60006 | KAISER FOUNDATION HEALTH PLAN INC. | — | $2K | $2K | 0.66% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ARTHUR J. GALLAGHER & CO. | 4100 NEWPORT PLACE DRIVE, SUITE 650 NEWPORT BEACH, CA 92660 | KAISER FOUNDATION HEALTH PLAN INC. | $4K | — | $4K | 4.03% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ARTHUR J. GALLAGHER & CO. | P.O. BOX 3009 ARLINGTON HEIGHTS, IL 60006 | KAISER FOUNDATION HEALTH PLAN INC. | — | $712 | $712 | 0.67% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ARTHUR J. GALLAGHER & CO. | 4100 NEWPORT PLACE DRIVE, SUITE 650 NEWPORT BEACH, CA 92660 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $9K | $2K | $11K | 17.55% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ARTHUR J. GALLAGHER & CO. | 4100 NEWPORT PLACE DRIVE, SUITE 650 NEWPORT BEACH, CA 92660 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $8K | $1K | $9K | 17.02% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ARTHUR J. GALLAGHER & CO. | 2850 GOLF ROAD, 5TH FLOOR ROLLING MEADOWS, IL 60008 | GUARDIAN | $16K | — | $16K | 31.73% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ARTHUR J. GALLAGHER & CO. | 4100 NEWPORT PLACE DRIVE, SUITE 650 NEWPORT BEACH, CA 92660 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | $381 | $4K | 16.54% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 4100 NEWPORT PLACE DRIVE, SUITE 650 NEWPORT BEACH, CA 92660 | BLUECROSS BLUESHIELD OF TEXAS | $938 | $45 | $983 | 4.92% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ARTHUR J. GALLAGHER & CO. | 4100 NEWPORT PLACE DRIVE, SUITE 650 NEWPORT BEACH, CA 92660 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $409 | — | $409 | 14.99% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ARTHUR J. GALLAGHER & CO. | 4100 NEWPORT PLACE DRIVE, SUITE 650 NEWPORT BEACH, CA 92660 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $350 | — | $350 | 14.99% |
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 | 399 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 404 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 250 | $2.2M |
| Dental | GUARDIAN | 378 | $51K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 398 | $61K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 398 | $25K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 398 | $53K |
| Prescription drug(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC. | 117 | $395K |
| Other(3 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 398 | $66K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 398 | — |
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.