| 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 | $131K | $0 | $131K | 4.42% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 14TH FLOOR ITASCA, IL 60143 | KAISER FOUNDATION HEALTH PLAN INC | $0 | $792 | $792 | 0.03% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE ITASCA, IL 60143 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $16K | $0 | $16K | 4.97% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 14TH FLOOR ITASCA, IL 60143 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | $1K | $8K | 12.11% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE ITASCA, IL 60143 | EYEMED VISION CARE | $2K | $0 | $2K | 5.01% |
| CHARLES EDWARD WILLIAMS3 Filed as: CHARLES E. WILLIAMS | 847 NORTH HOLLYWOOD WAY SUITE 204 BURBANK, CA 91505 | CONTINENTAL AMERICAN INSURANCE COMPANY | $367 | $0 | $367 | 2.68% |
| BARBARA S. BARNETT3 | 847 NORTH HOLLYWOOD WAY SUITE 204 BURBANK, CA 91505 | CONTINENTAL AMERICAN INSURANCE COMPANY | $304 | $0 | $304 | 2.22% |
| LABAN M. SPALDING3 | 4297 KLUME AVENUE STUDIO CITY, CA 91602 | CONTINENTAL AMERICAN INSURANCE COMPANY | $170 | $0 | $170 | 1.24% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD 6TH FLOOR GLENDALE, CA 91203 | CONTINENTAL AMERICAN INSURANCE COMPANY | $151 | $0 | $151 | 1.10% |
| ADAM H MICHAELS3 Filed as: ADAM H. MICHAELS | UNKNOWN LOS ANGELES, CA 90049 | CONTINENTAL AMERICAN INSURANCE COMPANY | $89 | $0 | $89 | 0.65% |
| CHRISTOPHER HAGER AND OTHER AGENTS3 | 12121 WILSHIRE BOULEVARD SUITE 1000 LOS ANGELES, CA 90025 | CONTINENTAL AMERICAN INSURANCE COMPANY | $45 | $0 | $45 | 0.33% |
| MICHAEL C WALKER3 Filed as: MICHAEL A. STACHOWIAK | 474 SOUTH FRANKLIN STREET DENVER, CO 80209 | CONTINENTAL AMERICAN INSURANCE COMPANY | $27 | $0 | $27 | 0.20% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 221 WEST 6TH STREET AUSTIN, TX 78701 | MANAGED HEALTH NETWORK | $581 | $0 | $581 | 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 | 383 | 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) | 383 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 642 | $3.0M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 329 | $330K |
| Vision | EYEMED VISION CARE | 569 | $31K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 383 | $63K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 642 | $3.0M |
| Other(3 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 383 | $89K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 642 | — |
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.