| 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 | $119K | — | $119K | 3.95% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 14TH FLOOR ITASCA, IL 60143 | KAISER FOUNDATION HEALTH PLAN INC | — | $3K | $3K | 0.10% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE ITASCA, IL 60143 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $16K | — | $16K | 4.97% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 14TH FLOOR ITASCA, IL 60143 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $7K | — | $7K | 10.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE ITASCA, IL 60143 | EYEMED VISION CARE | $1K | — | $1K | 5.02% |
| CHARLES EDWARD WILLIAMS3 Filed as: CHARLES E. WILLIAMS | 847 NORTH HOLLYWOOD WAY SUITE 204 BURBANK, CA 91505 | CONTINENTAL AMERICAN INSURANCE COMPANY | $389 | — | $389 | 2.69% |
| BARBARA S. BARNETT3 Filed as: BARBARA S BARNETT | 847 NORTH HOLLYWOOD WAY SUITE 204 BURBANK, CA 91505 | CONTINENTAL AMERICAN INSURANCE COMPANY | $361 | — | $361 | 2.49% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD 6TH FLOOR GLENDALE, CA 91203 | CONTINENTAL AMERICAN INSURANCE COMPANY | $195 | — | $195 | 1.35% |
| LEBAN MSPALDING3 | 4297 KLUME AVENUE STUDIO CITY, CA 91602 | CONTINENTAL AMERICAN INSURANCE COMPANY | $189 | — | $189 | 1.31% |
| ADAM H MICHAELS3 Filed as: ADAM H. MICHAELS | 12121 WILSHIRE BOULEVARD SUITE 1000 LOS ANGELES, CA 90025 | CONTINENTAL AMERICAN INSURANCE COMPANY | $95 | — | $95 | 0.66% |
| MICHAEL J LENEVEU3 Filed as: MICHAEL STACHOWIAK AND OTHER AGENTS | 25 FALCON HILLS DRIVE HIGHLANDS RANCH, CO 80126 | CONTINENTAL AMERICAN INSURANCE COMPANY | $58 | — | $58 | 0.40% |
| LILY YAN3 | 3122 DONA MARTA DRIVE STUDIO CITY, CA 91604 | CONTINENTAL AMERICAN INSURANCE COMPANY | $31 | — | $31 | 0.21% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 4100 NEWORT PLACE DRIVE, SUITE 650 NEWPORT BEACH, CA 92660 | MANAGED HEALTH NETWORK | $616 | — | $616 | 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 | 363 | 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) | 363 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 645 | $3.0M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 340 | $316K |
| Vision | EYEMED VISION CARE | 554 | $29K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 363 | $66K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 645 | $3.0M |
| Other(3 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 377 | $93K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 645 | — |
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.