| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD SUITE 600 GLENDALE, CA 91203 | KAISER FOUNDATION HEALTH PLAN INC | $123K | — | $123K | 3.97% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE ITASCA, IL 60143 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $15K | — | $15K | 4.97% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 14TH FLOOR ITASCA, IL 60143 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | $2K | $8K | 13.78% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE ITASCA, IL 60143 | EYEMED VISION CARE | $1K | — | $1K | 4.98% |
| BARBARA S. BARNETT3 | 847 NORTH HOLLYWOOD WAY SUITE 204 BURBANK, CA 91505 | CONTINENTAL AMERICAN INSURANCE COMPANY | $858 | — | $858 | 4.39% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD SUITE 600 GLENDALE, CA 91203 | CONTINENTAL AMERICAN INSURANCE COMPANY | $619 | — | $619 | 3.17% |
| CHARLES EDWARD WILLIAMS3 Filed as: CHARLES E. WILLIAMS | 847 NORTH HOLLYWOOD WAY SUITE 204 BURBANK, CA 91505 | CONTINENTAL AMERICAN INSURANCE COMPANY | $561 | — | $561 | 2.87% |
| L MATTHEW SPALDING3 Filed as: MATTHEW L. SPALDING | 4297 KLUME AVENUE STUDIO CITY, CA 91602 | CONTINENTAL AMERICAN INSURANCE COMPANY | $337 | — | $337 | 1.73% |
| ADAM H MICHAELS3 Filed as: ADAM H. MICHAELS | 12121 WILSHIRE BOULEVARD SUITE 1000 LOS ANGELES, CA 90025 | CONTINENTAL AMERICAN INSURANCE COMPANY | $152 | — | $152 | 0.78% |
| LILY YAN3 | 3122 DONA MARTA DRIVE STUDIO CITY, CA 91604 | CONTINENTAL AMERICAN INSURANCE COMPANY | $118 | — | $118 | 0.60% |
| MICHAEL R. FISHER3 Filed as: MICHAEL R. FISHER AND OTHER AGENTS | 12121 WILSHIRE BOULEVARD SUITE 1000 LOS ANGELES, CA 90025 | CONTINENTAL AMERICAN INSURANCE COMPANY | $96 | — | $96 | 0.49% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 14TH FLOOR ITASCA, IL 60143 | MANAGED HEALTH NETWORK | $600 | — | $600 | 5.00% |
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 | 371 | 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) | 371 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 656 | $3.1M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 342 | $295K |
| Vision | EYEMED VISION CARE | 537 | $29K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 371 | $61K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 656 | $3.1M |
| Other(3 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 371 | $92K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 656 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.