| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 4100 NEWPORT PLACE DRIVE, SUITE 650 NEWPORT BEACH, CA 92660 | CALIFORNIA PHYSICIANS SERVICES | $158K | $3K | $161K | 5.11% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD 6TH FLOOR GLENDALE, CA 91203 | AETNA LIFE INSURANCE COMPANY | $27K | — | $27K | 9.03% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 6399 FIDDLERS GREEN CIRCLE SUITE 200 DENVER, CO 80111 | AETNA LIFE INSURANCE COMPANY | — | $115 | $115 | 0.04% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 14TH FLOOR ITASCA, IL 60143 | VISION SERVICE PLAN | $1K | — | $1K | 4.51% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD SUITE 600 GLENDALE, CA 91203 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 7.03% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE ITASCA, IL 60143 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $1K | $1K | 4.66% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD 6TH FLOOR GLENDALE, CA 91203 | AFLAC | $825 | — | $825 | 3.82% |
| ARNOLD TARIN3 Filed as: ARNOLD TARIN AND VARIUS AGENTS | 1757 11TH STREET SANTA MONICA, CA 90404 | AFLAC | $744 | $7 | $751 | 3.48% |
| DAWN A CHRISTENSEN3 Filed as: DAWN A. CHRISTENSEN | 24516 APPLE STREET 6TH FLOOR NEWHALL, CA 91321 | AFLAC | $690 | — | $690 | 3.20% |
| DAVID BRYANT3 Filed as: DAVID H. BRYANT | 2263 FOX HILLS DRIVE APARTMENT 101 LOS ANGELES, CA 90064 | AFLAC | $468 | $33 | $501 | 2.32% |
| OLENA K SHEA3 | 1502 BROADWAY UNIT 308 SANTA MONICA, CA 90404 | AFLAC | $145 | $7 | $152 | 0.70% |
| DAVID A BURKHARDT3 | 428 WHITON ROAD BRANCHBURG, NJ 08853 | AFLAC | $138 | — | $138 | 0.64% |
| ADAM H MICHAELS3 Filed as: ADAM H. MICHAELS | 12121 WILSHIRE BOULEVARD SUITE 1000 LOS ANGELES, CA 90064 | AFLAC | $93 | $7 | $100 | 0.46% |
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 | 349 | 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) | 349 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA PHYSICIANS SERVICES | 670 | $3.2M |
| Dental | AETNA LIFE INSURANCE COMPANY | 640 | $297K |
| Vision | VISION SERVICE PLAN | 249 | $32K |
| Life insurance | AETNA LIFE INSURANCE COMPANY | 640 | $297K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 344 | $30K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 344 | $30K |
| Prescription drug | CALIFORNIA PHYSICIANS SERVICES | 670 | $3.2M |
| Other(3 contracts, 3 carriers) | AETNA LIFE INSURANCE COMPANY | 640 | $348K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 670 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.