| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | KAISER FOUNDATION HEALTH PLAN INC | $134K | $10K | $144K | 3.99% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $8K | $0 | $8K | 2.57% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 18201 VON KARMAN AVENUE, SUITE 200 IRVINE, CA 92612 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $8K | $0 | $8K | 2.40% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | $862 | $7K | 11.36% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE ITASCA, IL 60143 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $1K | $0 | $1K | 3.83% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, SUITE 1000 ROLLING MEADOWS, IL 60008 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $387 | $0 | $387 | 1.18% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 221 WEST 6TH STREET AUSTIN, TX 78701 | MANAGED HEALTH NETWORK | $669 | $0 | $669 | 5.00% |
| CHARLES EDWARD WILLIAMS3 Filed as: CHARLES E. WILLIAMS | 847 NORTH HOLLYWOOD WAY, SUITE 204 BURBANK, CA 91505 | CONTINENTAL AMERICAN INSURANCE COMPANY | $237 | $0 | $237 | 2.59% |
| BARBARA S. BARNETT3 | 847 NORTH HOLLYWOOD WAY, SUITE 204 BURBANK, CA 91505 | CONTINENTAL AMERICAN INSURANCE COMPANY | $187 | $0 | $187 | 2.04% |
| LABAN M. SPALDING3 | 4297 KLUME AVENUE STUDIO CITY, CA 91602 | CONTINENTAL AMERICAN INSURANCE COMPANY | $106 | $0 | $106 | 1.16% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD 6TH FLOOR GLENDALE, CA 91203 | CONTINENTAL AMERICAN INSURANCE COMPANY | $90 | $0 | $90 | 0.98% |
| ADAM H MICHAELS3 Filed as: ADAM H. MICHAELS | UNKNOWN LOS ANGELES, CA 90049 | CONTINENTAL AMERICAN INSURANCE COMPANY | $58 | $0 | $58 | 0.63% |
| CHRISTOPHER HAGER AND OTHER AGENTS3 | 8201 PARK HILL DRIVE LOS ANGELES, CA 90045 | CONTINENTAL AMERICAN INSURANCE COMPANY | $19 | $0 | $19 | 0.21% |
| MICHAEL C WALKER3 Filed as: MICHAEL A. STACHOWIAK | 595 ELM STREET WINNETKA, IL 60093 | CONTINENTAL AMERICAN INSURANCE COMPANY | $17 | $0 | $17 | 0.19% |
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 | 381 | 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) | 381 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 570 | $3.6M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 317 | $327K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 522 | $33K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 381 | $63K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 570 | $3.6M |
| Other(3 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 381 | $86K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 570 | — |
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.