| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 14TH FLOOR ITASCA, IL 60143 | BLUE CROSS OF CALIFORNIA | $101K | — | $101K | 3.29% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD SUITE 600 GLENDALE, CA 91203 | KAISER FOUNDATION HEALTH PLAN INC | $45K | — | $45K | 2.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD 6TH FLOOR GLENDALE, CA 91203 | AETNA LIFE INSURANCE COMPANY | $51K | — | $51K | 8.14% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 6399 FIDDLERS GREEN CIRCLE SUITE 200 DENVER, CO 80111 | AETNA LIFE INSURANCE COMPANY | — | $115 | $115 | 0.02% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD 6TH FLOOR GLENDALE, CA 91203 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $18K | — | $18K | 8.31% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 400 MIDLAND DRIVE, SUITE 300 MOUNT LAUREL, NJ 08054 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $2K | $2K | 0.73% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 14TH FLOOR ITASCA, IL 60143 | VISION SERVICE PLAN | $2K | — | $2K | 2.87% |
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 | 943 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 12 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 960 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 614 | $5.3M |
| Dental | AETNA LIFE INSURANCE COMPANY | 1,545 | $628K |
| Vision | VISION SERVICE PLAN | 369 | $77K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 943 | $213K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 943 | $213K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 943 | $213K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 614 | $5.3M |
| Other(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 943 | $213K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,545 | — |
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.