| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 500 NORTH SANTA FE VISALIA, CA 93292 | CALIFORNIA PHYSICIANS SERVICE | $7K | $52K | $59K | 3.20% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 18201 VON KARMAN AVENUE, SUITE 200 IRVINE, CA 92612 | KAISER FOUNDATION HEALTH PLAN, INC. | $26K | $0 | $26K | 3.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 18201 VON KARMAN AVENUE, SUITE 200 IRVINE, CA 92612 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $10K | $0 | $10K | 9.20% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 5TH FLOOR ROLLING MEADOWS, IL 60008 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $1K | $1K | 1.15% |
| TELLUS BROKERAGE CONNECTIONS3 Filed as: TELLUS BROKERAGE CONNECTIONS, INC. | 4315 NORTH FRONT STREET HARRISBURG, PA 17110 | TRANSAMERICA LIFE INSURANCE COMPANY | $1K | $0 | $1K | 1.79% |
| JOHN M. GILMORE, INC.3 | 200 SOUTH LOS ROBLES, SUITE 200 PASADENA, CA 91101 | TRANSAMERICA LIFE INSURANCE COMPANY | $1K | $0 | $1K | 1.51% |
| ADVANCED LTC INSURANCE SERVICES3 | 520 EAST WILSON AVENUE, SUITE 210 GLENDALE, CA 91206 | TRANSAMERICA LIFE INSURANCE COMPANY | $654 | $0 | $654 | 0.99% |
| LEISURE WERDEN & TERRY AGENCY3 | 200 SOUTH LOS ROBLES, SUITE 435 PASADENA, CA 91101 | TRANSAMERICA LIFE INSURANCE COMPANY | $330 | $0 | $330 | 0.50% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD SUITE 600 GLENDALE, CA 91203 | UNITEDHEALTHCARE INSURANCE COMPANY | $6K | $0 | $6K | 29.76% |
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 | 157 | 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) | 157 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 210 | $2.7M |
| Dental | CALIFORNIA PHYSICIANS SERVICE | 210 | $1.8M |
| Vision | CALIFORNIA PHYSICIANS SERVICE | 210 | $1.8M |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 157 | $105K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 157 | $105K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 157 | $105K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 210 | $2.7M |
| Other(4 contracts, 4 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 160 | $193K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 210 | — |
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."
No prospect flags tripped on this filing.