| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 100 SMITH RANCH ROAD SUITE 112 SAN RAFAEL, CA 94903 | CALIFORNIA PHYSICIANS SERVICE | $24K | $410 | $24K | 5.09% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD SUITE 600 GLENDALE, CA 91203 | KAISER FOUNDATION HEALTH PLAN INC | $19K | $0 | $19K | 5.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE 14TH FLOOR ITASCA, IL 60143 | KAISER FOUNDATION HEALTH PLAN INC | $0 | $62 | $62 | 0.02% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD 6TH FLOOR GLENDALE, CA 91203 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $8K | $127 | $8K | 14.49% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD 6TH FLOOR GLENDALE, CA 91203 | UNION SECURITY INSURANCE COMPANY | $2K | $0 | $2K | 5.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD GLENDALE, CA 91203 | EYEMED VISION CARE | $1K | $0 | $1K | 9.80% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD 6TH FLOOR GLENDALE, CA 91203 | UDC DENTAL OF CALIFORNIA, INC. | $1K | $0 | $1K | 10.00% |
| HEINZ SCHULMEISTER3 | 2663 CENTINELA AVENUE SUITE 202 SANTA MONICA, CA 90405 | AFLAC | $330 | $0 | $330 | 13.04% |
| JACOB BURNS INC.3 Filed as: JACOB BURNS, INC. | 12121 WILSHIRE BOULEVARD SUITE 1000 LOS ANGELES, CA 90025 | AFLAC | $78 | $0 | $78 | 3.08% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY AND OTHER AGENTS | 3475 EAST FOOTHILL BOULEVARD PASADENA, CA 91107 | AFLAC | $39 | $0 | $39 | 1.54% |
| TOMMY L JOHNSON JR3 Filed as: TOMMY JOHNSON, JR. | 711 SOUTH OLIVE STREET SUITE 314 LOS ANGELES, CA 90014 | AFLAC | $33 | $0 | $33 | 1.30% |
| JOSEPH L. AGAGON3 Filed as: JOSEPH AGAGON | 421 WEST BROADWAY LONG BEACH, CA 90802 | AFLAC | $15 | $0 | $15 | 0.59% |
| STEVEN R. JOHNSON3 Filed as: STEVEN JOHNSON | 6167 BRISTOL PARKWAY SUITE 106 CULVER CITY, CA 90230 | AFLAC | $13 | $0 | $13 | 0.51% |
| OLENA K SHEA3 Filed as: OLENA SHEA | 3 MITCHELL PLACE SUITE 18C NEW YORK, NY 10017 | AFLAC | $12 | $0 | $12 | 0.47% |
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 | 98 | 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) | 98 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 89 | $853K |
| Dental(2 contracts, 2 carriers) | UNION SECURITY INSURANCE COMPANY | 63 | $53K |
| Vision | EYEMED VISION CARE | 136 | $14K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 98 | $58K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 98 | $58K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 98 | $58K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 89 | $853K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 98 | $60K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 136 | — |
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.