| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY, INC. | PO BOX 908 FORT WORTH, TX 76101 | BLUE SHIELD OF CALIFORNIA | $5K | $35K | $40K | 1.95% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 500 N SANTA FE VISALIA, CA 93292 | BLUE SHIELD OF CALIFORNIA | $4K | $27K | $31K | 1.51% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY, INC. | PO BOX 908 FORT WORTH, TX 76101 | KAISER FOUNDATION HEALTH PLAN, INC. | $14K | $0 | $14K | 1.79% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 18201 VON KARMAN AVE, STE. 200 IRVINE, CA 92612 | KAISER FOUNDATION HEALTH PLAN, INC. | $12K | $0 | $12K | 1.46% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 18201 VON KARMAN AVE IRVINE, CA 62612 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | $0 | $6K | 10.78% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $799 | $799 | 1.46% |
| JOHN M. GILMORE, INC.3 | 200 S LOS ROBLES, STE. 200 PASEDENA, CA 91101 | TRANSAMERICA LIFE INSURANCE COMPANY | $2K | $0 | $2K | 4.28% |
| ADVANCED LTC INSURANCE SERVICES3 | 520 E WILSON AVE, STE. 210 GLENDALE, CA 91206 | TRANSAMERICA LIFE INSURANCE COMPANY | $170 | $0 | $170 | 0.36% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 18201 VON KARMAN AVE IRVINE, CA 92612 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $0 | $3K | 10.93% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $538 | $538 | 1.82% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY, INC. | PO BOX 908 FORT WORTH, TX 76101 | UNITEDHEALTHCARE INSURANCE COMPANY | $3K | $0 | $3K | 11.44% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 18201 VON KARMAN AVE IRVINE, CA 92612 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $990 | $0 | $990 | 11.20% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $199 | $199 | 2.25% |
| HIGGINBOTHAM INS AGENCY INC3 Filed as: HIGGINBOTHAM INSURANCE AGENCY, INC. | PO BOX 908 FORT WORTH, TX 76101 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $1K | $0 | $1K | 17.42% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 18201 VON KARMAN AVE IRVINE, CA 92612 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $500 | $0 | $500 | 10.91% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $66 | $66 | 1.44% |
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 | 160 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 162 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE SHIELD OF CALIFORNIA | 311 | $2.9M |
| Dental | BLUE SHIELD OF CALIFORNIA | 311 | $2.1M |
| Vision | BLUE SHIELD OF CALIFORNIA | 311 | $2.1M |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $55K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $5K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $30K |
| Prescription drug | BLUE SHIELD OF CALIFORNIA | 311 | $2.1M |
| Other(5 contracts, 4 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 125 | $148K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 311 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.