| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 5TH FLOOR ROLLING MEADOWS, IL 60008 | BLUE CROSS OF CALIFORNIA | $197K | $0 | $197K | 4.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD SUITE 600 GLENDALE, CA 91203 | KAISER FOUNDATION HEALTH PLAN INC | $69K | $0 | $69K | 1.99% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | KAISER FOUNDATION HEALTH PLAN INC | $0 | $11K | $11K | 0.32% |
| JAMES DUNCAN DAVIDSON3 | 1820 EAST FIRST STREET, SUITE 400 SANTA ANA, CA 92705 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $11K | $0 | $11K | 9.78% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 6967 SOUTH RIVER GATE DRIVE SUITE 200 MIDVALE, UT 84047 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $6K | $0 | $6K | 5.23% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $0 | $224 | $224 | 0.20% |
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 | 541 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 20 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 565 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 1,286 | $8.4M |
| Dental | BLUE CROSS OF CALIFORNIA | 1,286 | $4.9M |
| Vision | BLUE CROSS OF CALIFORNIA | 1,286 | $4.9M |
| Life insurance | BLUE CROSS OF CALIFORNIA | 1,286 | $4.9M |
| Short-term disability | BLUE CROSS OF CALIFORNIA | 1,286 | $4.9M |
| Long-term disability | BLUE CROSS OF CALIFORNIA | 1,286 | $4.9M |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 1,286 | $8.4M |
| Other(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 1,286 | $5.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,286 | — |
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."
No prospect flags tripped on this filing.