| 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 | $161K | $0 | $161K | 3.98% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ARTHUR J. GALLAGHER - IRVINE | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | KAISER FOUNDATION HEALTH PLAN INC | $0 | $11K | $11K | 0.27% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $19K | $2K | $21K | 5.45% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 21ST FLOOR ARLINGTON HEIGHTS, IL 60006 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | $714 | $6K | 11.35% |
| 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. | $2K | $0 | $2K | 4.55% |
| CHARLES EDWARD WILLIAMS3 Filed as: CHARLES E. WILLIAMS | 847 NORTH HOLLYWOOD WAY, SUITE 204 BURBANK, CA 91505 | CONTINENTAL AMERICAN INSURANCE COMPANY | $91 | $0 | $91 | 1.65% |
| BARBARA S. BARNETT3 | 847 NORTH HOLLYWOOD WAY, SUITE 204 BURBANK, CA 91505 | CONTINENTAL AMERICAN INSURANCE COMPANY | $72 | $0 | $72 | 1.31% |
| LABAN M. SPALDING3 | 4297 KLUME AVENUE STUDIO CITY, CA 91602 | CONTINENTAL AMERICAN INSURANCE COMPANY | $41 | $0 | $41 | 0.74% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD 6TH FLOOR GLENDALE, CA 91203 | CONTINENTAL AMERICAN INSURANCE COMPANY | $34 | $0 | $34 | 0.62% |
| ADAM H MICHAELS3 Filed as: ADAM H. MICHAELS | 2922 CORDA LANE LOS ANGELES, CA 90049 | CONTINENTAL AMERICAN INSURANCE COMPANY | $22 | $0 | $22 | 0.40% |
| CHRISTOPHER HAGER3 | 8201 PARK HILL DRIVE LOS ANGELES, CA 90045 | CONTINENTAL AMERICAN INSURANCE COMPANY | $6 | $0 | $6 | 0.11% |
| MICHAEL C WALKER3 Filed as: MICHAEL A. STACHOWIAK | 595 ELM STREET WINNETKA, IL 60093 | CONTINENTAL AMERICAN INSURANCE COMPANY | $6 | $0 | $6 | 0.11% |
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 | 392 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 393 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 645 | $4.0M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 414 | $378K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 609 | $36K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 484 | $53K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 645 | $4.0M |
| Other(3 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 505 | $69K |
| 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.