| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 505 N BRAND BLVD STE 600 GLENDALE, CA 912033944 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | — | $4K | $4K | 3.47% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INCE | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | — | $2K | $2K | 1.83% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 505 N BRAND BLVD STE 600 GLENDALE, CA 912033944 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | — | $2K | $2K | 2.02% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 600063009 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | — | $2K | $2K | 1.89% |
| SYNERGY ENROLLMENT AND BENEFITS LLC3 Filed as: SYNERGY ENROLLMENT & BENEFITS LLC | 9370 SKY PARK CT STE 250 SAN DIEGO, CA 921235380 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | — | $1K | $1K | 1.38% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 505 N BRAND BLVD STE 600 GLENDALE, CA 912033944 | METROPOLITAN LIFE INSURANCE COMPANY | — | $2K | $2K | 3.02% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 505 N BRAND BLVD FL 6 GLENDALE, CA 912033944 | METROPOLITAN LIFE INSURANCE COMPANY | — | $2K | $2K | 2.41% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 1111 SUPERIOR AVE E STE 1601 CLEAVLAND, OH 441142522 | METROPOLITAN LIFE INSURANCE COMPANY | — | $3 | $3 | 0.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 505 N BRAND BLVD STE 600 GLENDALE, CA 912033944 | METROPOLITAN LIFE INSURANCE COMPANY | — | $2K | $2K | 4.11% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 505 N BRAND BLVD 6 GLENDALE, CA 912033944 | METROPOLITAN LIFE INSURANCE COMPANY | — | $2K | $2K | 3.13% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 111 SUPERIOR AVE E STE 1601 CLEVELAND, OH 441142522 | METROPOLITAN LIFE INSURANCE COMPANY | — | $3 | $3 | 0.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 505 N BRAND BLVD FL 6 GLENDALE, CA 912033944 | METROPOLITAN LIFE INSURANCE COMPANY | — | $2K | $2K | 3.98% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 505 N BRAND BLVD 600 GLENDALE, CA 912033944 | METROPOLITAN LIFE INSURANCE COMPANY | — | $1K | $1K | 3.23% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 1111 SUPERIOR AVE E STE 1601 CLEAVLAND, OH 441142522 | METROPOLITAN LIFE INSURANCE COMPANY | — | $1 | $1 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ARTHUR J GALLAGHER & CO INS BROKERS EIN 94-3015711 BROKER | Insurance agents and brokers Service code 22 | 505 N BRAND AVE STE 600 GLENDALE, CA 91203 | $908K |
| MVI ADMINISTRATORS INC. EIN 33-0393692 ADMINISTRATOR | Plan Administrator Service code 14 | 2615 CAMINO DEL RIO SOUTH SUITE 201 SAN DIEGO, CA 92108 | $563K |
| EMPLOYEE BENEFITS LAW GROUP PC EIN 68-0195995 LEGAL | Legal Service code 29 | 620 COOLIDAGE DR STE 100 FOLSOM, CA 956303182 | $23K |
| RBTK, LLP EIN 33-0567239 INDEPENDENT AUDITOR | Accounting (including auditing); Direct payment from the plan Service code 10 | 5675 RUFFIN ROAD STE 300 SAN DIEGO, CA 92123 | $19K |
| MARSH & MCLENNAN AGENCY, LLC EIN 26-3237576 INSURANCE SERVICES | Other insurance fees and expenses Service code 73 | PO BOX 85638 SAN DIEGO, CA 921865638 | $18K |
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 | 1,777 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 11 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,788 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HEALTHNET | 1,176 | $12.3M |
| Dental(2 contracts) | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | 735 | $205K |
| Other(3 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 2,754 | $164K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,754 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.