| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 330 MADISON AVENUE, 7TH FLOOR NEW YORK, NY 10017 | AETNA LIFE INSURANCE COMPANY | $271K | $7K | $278K | 3.31% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO ADVISORS LLC | PO BOX 2700 WORCESTER, MA 01613 | METROPOLITAN LIFE INSURANCE COMPANY | $88K | $27 | $88K | 8.07% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 21250 HAWTHORNE BOULEVARD SUITE 600 TORRANCE, CA 90503 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $27 | $2K | 0.23% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 1018 WEST 9TH AVENUE KING OF PRUSSIA, PA 19406 | METROPOLITAN LIFE INSURANCE COMPANY | — | $723 | $723 | 0.07% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 959 SKYWAY ROAD, 2ND FLOOR SAN CARLOS, CA 94070 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $43K | — | $43K | 9.16% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 21250 HAWTHORNE BOULEVARD SUITE 600 TORRANCE, CA 90503 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $3K | $3K | 0.71% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 330 MADISON AVENUE, 7TH FLOOR NEW YORK, NY 10017 | AETNA HEALTH, INC. | $14K | $28K | $42K | 9.46% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 21250 HAWTHORNE BOULEVARD SUITE 600 TORRANCE, CA 90503 | VISION SERVICE PLAN | $3K | — | $3K | 2.39% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 21250 HAWTHORNE BOULEVARD SUITE 600 TORRANCE, CA 90503 | HYATT LEGAL PLANS | $5K | — | $5K | 9.98% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 64 MONROE AVENUE NW, SUITE 300 GRAND RAPIDS, MI 49503 | HYATT LEGAL PLANS | — | $566 | $566 | 1.17% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 11017 COBBLEROCK DRIVE, SUITE 100 RANCHO CORDOVA, CA 95670 | HYATT LEGAL PLANS | — | $350 | $350 | 0.72% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 1018 WEST 9TH AVENUE KING OF PRUSSIA, PA 19406 | HYATT LEGAL PLANS | — | $27 | $27 | 0.06% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 21250 HAWTHORNE BOULEVARD SUITE 600 TORRANCE, CA 90503 | BLUE CROSS OF CALIFORNIA | $292 | — | $292 | 1.90% |
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 | 630 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 630 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 1,710 | $8.9M |
| Dental | AETNA LIFE INSURANCE COMPANY | 1,710 | $8.4M |
| Vision | VISION SERVICE PLAN | 641 | $121K |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 633 | $1.6M |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 631 | $472K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 631 | $472K |
| Prescription drug(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 1,710 | $8.9M |
| Other(4 contracts, 4 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 645 | $1.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,710 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.