| 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. | $32K | $0 | $32K | 4.97% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF ROAD 5TH FL ROLLING MEADOWS, IL 60008 | SUN LIFE ASSURANCE COMPANY OF CANADA | $5K | $510 | $5K | 12.07% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICES | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 91361 | SUN LIFE ASSURANCE COMPANY OF CANADA | $2K | $0 | $2K | 5.43% |
| 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 | $4K | $0 | $4K | 10.77% |
| 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 | $3K | $3K | 8.49% |
| GALLAGHER BENEFIT SERVICES, INC.4 Filed as: GALLAGHER BENEFIT SERVICES INC | 18201 VON KARMAN AVE STE 200 IRVINE, CA 926121069 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $357 | $0 | $357 | 26.66% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 3655 NOBEL DR SUITE 450 SAN DIEGO, CA 92121 | MEDIEXCEL HEALTH PLAN | $405 | $0 | $405 | 100.00% |
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 | 114 | 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) | 114 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 65 | $634K |
| Dental | SUN LIFE ASSURANCE COMPANY OF CANADA | 59 | $42K |
| Vision | SUN LIFE ASSURANCE COMPANY OF CANADA | 59 | $42K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 99 | $37K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 99 | $37K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 99 | $37K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 99 | $39K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 99 | — |
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."
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.