| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | 10940 WHITE ROCK ROAD 2ND FLOOR RANCHO CORDOVA, CA 95670 | BLUE SHIELD OF CALIFORNIA | $243K | $6K | $248K | 4.03% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | 600 HIGHWAY 169 SOUTH 12TH FL SAINT LOUIS PARK, MN 55426 | KAISER FOUNDATION HEALTH PLAN INC | $110K | — | $110K | 3.68% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 21250 HAWTHORNE BLVD, STE 600 TORRANCE, CA 90503 | METROPOLITAN LIFE INSURANCE COMPANY | $28K | $27 | $28K | 4.31% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 21250 HAWTHORNE BLVD, STE 600 TORRANCE, CA 90503 | METROPOLITAN LIFE INSURANCE COMPANY | — | $9K | $9K | 1.41% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 21250 HAWTHORNE BLVD, STE 600 TORRANCE, CA 90503 | METROPOLITAN LIFE INSURANCE COMPANY | — | $27 | $27 | 0.00% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | 21250 HAWTHORNE BLVD STE 600 TORRANCE, CA 90503 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $47K | $2K | $49K | 14.43% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | 21250 HAWTHORNE BLVD STE 600 TORRANCE, CA 90503 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $6K | — | $6K | 2.49% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 21250 HAWTHORNE BLVD STE 600 TORRANCE, CA 90503 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $5K | — | $5K | 4.33% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 1018 W 9TH AVE KING OF PRUSSIA, PA 19406 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | — | $2K | $2K | 1.42% |
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 | 990 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 997 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | BLUE SHIELD OF CALIFORNIA | 602 | $9.4M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 638 | $756K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 990 | $343K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 990 | $343K |
| Prescription drug(3 contracts, 3 carriers) | BLUE SHIELD OF CALIFORNIA | 602 | $9.4M |
| Other(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 990 | $615K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 990 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.