| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 18201 VON KARMAN AVENUE, SUITE 200 IRVINE, CA 92612 | NIPPON LIFE INSURANCE COMPANY OF AMERICA | $53K | $0 | $53K | 5.44% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 18201 VON KARMAN AVENUE, SUITE 200 IRVINE, CA 92612 | METROPOLITAN LIFE INSURANCE COMPANY | $11K | $64 | $11K | 9.21% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $2K | $2K | 1.83% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD 6TH FLOOR GLENDALE, CA 91203 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $10K | $0 | $10K | 10.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 400 MIDLAND DRIVE, SUITE 300 MOUNT LAUREL, NJ 08054 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $519 | $0 | $519 | 0.50% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $55 | $55 | 0.05% |
| CLINT D SALMON3 Filed as: CLINT D. SALMON | 34 DOWNFIELD WAY TRABUCO CANYON, CA 92679 | AFLAC | $5K | $130 | $5K | 11.39% |
| PEGGY K SALMON3 Filed as: PEGGY K. SALMON | 2203 AVENIDA OLIVA SAN CLEMENTE, CA 92673 | AFLAC | $548 | $26 | $574 | 1.39% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | AFLAC | $332 | $0 | $332 | 0.80% |
| SCOTT W BLACKSHEAR AND OTHER AGENTS3 Filed as: SCOTT BLACKSHEAR AND OTHER AGENTS | 3453 CATHRYN DRIVE COLUMBUS, GA 31906 | AFLAC | $298 | $0 | $298 | 0.72% |
| STEPHANIE A REYNOSO3 Filed as: STEPHANIE A. REYNOSO | 21 CERVANTES NEWPORT BEACH, CA 92660 | AFLAC | $176 | $26 | $202 | 0.49% |
| CESAR A TORRES3 Filed as: CESAR A. TORRES | 24712 CORTA CRESTA DRIVE LAKE FOREST, CA 92630 | AFLAC | $98 | $0 | $98 | 0.24% |
| KRISTEN NICOLE GLENN3 | 1604 VIA TULIPAN SAN CLEMENTE, CA 92673 | AFLAC | $89 | $0 | $89 | 0.22% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 18201 VON KARMAN AVENUE, SUITE 200 IRVINE, CA 92612 | SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION | $237 | $0 | $237 | 9.17% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION | $0 | $54 | $54 | 2.09% |
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 | 158 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 162 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | NIPPON LIFE INSURANCE COMPANY OF AMERICA | 134 | $978K |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 311 | $120K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 311 | $117K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 156 | $104K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 156 | $104K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 156 | $104K |
| Prescription drug | NIPPON LIFE INSURANCE COMPANY OF AMERICA | 134 | $978K |
| Other(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 156 | $145K |
| 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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.