| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SVCS USA INC | 10940 WHITE ROCK ROAD 2ND FLR RANCHO CORDOVA, CA 95670 | CALIFORNIA PHYSICIANS' SERVICE | $139K | $5K | $144K | 3.12% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | DEPT 133667 PO BOX 3900 SAN FRANCISCO, CA 94139 | AETNA LIFE INSURANCE CO | $25K | $10K | $35K | 5.62% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO OINSURANCE SERVICES USA | 600 HIGHWAY 169 S 12TH FL SAINT LOUIS PARK, MN 55426 | KAISER FOUNDATION HEALTH PLAN INC | $14K | — | $14K | 2.75% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | PO BOX 39000 SAN FRANCISCO, CA 94139 | VISION SERVICE PLAN | $3K | — | $3K | 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 | 579 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 585 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 408 | $5.1M |
| Dental | AETNA LIFE INSURANCE CO | 1,004 | $629K |
| Vision | VISION SERVICE PLAN | 350 | $61K |
| Life insurance | AETNA LIFE INSURANCE CO | 1,004 | $629K |
| Short-term disability | AETNA LIFE INSURANCE CO | 1,004 | $629K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 408 | $5.1M |
| Other(2 contracts, 2 carriers) | AETNA LIFE INSURANCE CO | 1,004 | $633K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,004 | — |
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.