| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | BLUE CROSS OF CALIFORNIA | $165K | $0 | $165K | 4.89% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 323 WEST LAKESIDE AVENUE, SUITE 410 CLEVELAND, OH 44113 | BLUE CROSS OF CALIFORNIA | $0 | $2K | $2K | 0.05% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 18201 VON KARMAN AVENUE, SUITE 200 IRVINE, CA 92612 | METROPOLITAN LIFE INSURANCE COMPANY | $19K | $106 | $19K | 10.02% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 95287 CHICAGO, IL 60690 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $3K | $3K | 1.62% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 4137 CLINTON, IA 52733 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $6K | $830 | $7K | 17.05% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | VISION SERVICE PLAN | $1K | $0 | $1K | 4.84% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 18201 VON KARMAN AVENUE, SUITE 200 IRVINE, CA 92612 | FOUR EVER LIFE INSURANCE COMPANY | $454 | — | $454 | 15.01% |
| ANTHEM INSURANCE COMPANIES, INC.3 | 120 MONUMENT CIRCLE INDIANAPOLIS, IN 46204 | FOUR EVER LIFE INSURANCE COMPANY | — | $30 | $30 | 0.99% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 4100 NEWPORT PLACE, SUITE 650 NEWPORT BEACH, CA 92660 | ZURICH AMERICAN INSURANCE COMPANY | $147 | — | $147 | 15.00% |
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 | 107 | 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) | 107 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 320 | $3.4M |
| Dental(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 488 | $3.6M |
| Vision | VISION SERVICE PLAN | 103 | $27K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 2 | $40K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 2 | $40K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 2 | $40K |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 320 | $3.4M |
| Other(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 107 | $41K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 488 | — |
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.