| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 500 N BRAND BLVD STE 100 GLENDALE, CA 91203 | KAISER FOUNDATION HEALTH PLAN INC. | $33K | $0 | $33K | 5.05% |
| MARSH & MCLENNAN AGENCY LLC3 | LOCKBOX 740659 LOS ANGELES, CA 90074 | KAISER FOUNDATION HEALTH PLAN INC. | $29 | $0 | $29 | 0.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 505 N BRAND BLVD FL 6 GLENDALE, CA 91203 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $0 | $5K | 10.66% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 736 S STONE AVE LA GRANGE, IL 60525 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $597 | $597 | 1.16% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 10505 SORRENTO VALLEY RD. SUITE 200 SAN DIEGO, CA 92121 | MEDIEXCEL HEALTH PLAN | $1K | $0 | $1K | 5.26% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 600063009 | METROPOLITAN LIFE INSURANCE COMPANY | $390 | $205 | $595 | 15.63% |
| AMWINS3 Filed as: LISI LLC | 2677 N MAIN ST STE 800 SANTA ANA, CA 927056687 | METROPOLITAN LIFE INSURANCE COMPANY | $390 | $148 | $538 | 14.13% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLEANNAN AGENCY LLC | 9171 TOWNE CENTRE DR STE 500 SAN DIEGO, CA 921221238 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $33 | $33 | 0.87% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 95287 CHICAGO, IL 606945287 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $4 | $4 | 0.11% |
| MARSH & MCLENNAN AGENCY LLC3 | 6279 TRI RIDGE BLVD STE 400 LOVELAND, OH 451408320 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $3 | $3 | 0.08% |
| AMWINS3 Filed as: LISI LLC | 2677 N MAIN ST STE 800 SANTA ANA, CA 927056687 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $58 | $38 | $96 | 19.96% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 600006300 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $58 | $24 | $82 | 17.05% |
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 | 154 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 44 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 198 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 92 | $681K |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 0 | $4K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 0 | $4K |
| Life insurance(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 128 | $55K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 128 | $51K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 128 | $51K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 128 | $55K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 128 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.