| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SERVICS USA INC | 21250 HAWTHORNE BL #600 TORRANCE, CA 90503 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $143K | — | $143K | 4.17% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SERVICES USA INC | 21250 HAWTHORNE BLVD STE 600 TORRANCE, CA 90503 | METROPOLITAN LIFE INSURANCE COMPANY | $24K | — | $24K | 5.94% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SERVICES USA INC | 1018 W 9TH AVE KING OF PRUSSIA, PA 19406 | METROPOLITAN LIFE INSURANCE COMPANY | — | $5K | $5K | 1.35% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SVCS USA INC | 21250 HAWTHORNE BLVD STE 600 TORRANCE, CA 90503 | HARTFORD LIFE AND ACCIDENT | $8K | — | $8K | 5.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SVCS USA INC | 10 SOUTH WACKER DRIVE FLOOR 17 CHICAGO, IL 60606 | HARTFORD LIFE AND ACCIDENT | — | $3K | $3K | 1.97% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | 21250 HAWTHORNE BLVD, SUITE 600 TORRANCE, CA 90503 | DELAWARE AMERICAN LIFE INSURANCE COMPANY | $4K | — | $4K | 10.00% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | PO BOX 39000 SAN FRANCISCO, CA 94139 | VISION SERVICE PLAN | $1K | — | $1K | 4.13% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SERVICES USA INC | 21250 HAWTHORNE BLVD. STE 600 TORRANCE, CA 90503 | SAFEGUARD HEALTH PLANS, A CALIFORNIA CORPORATION | $159 | — | $159 | 6.17% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SERVICES USA INC | 1018 W 9TH AVE KING OF PRUSSIA, PA 19406 | SAFEGUARD HEALTH PLANS, A CALIFORNIA CORPORATION | — | $35 | $35 | 1.36% |
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 | 239 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 242 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 236 | $3.5M |
| Dental(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 756 | $449K |
| Vision(2 contracts, 2 carriers) | DELAWARE AMERICAN LIFE INSURANCE COMPANY | 240 | $79K |
| Life insurance(2 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 239 | $3.6M |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 239 | $162K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 239 | $162K |
| Prescription drug(2 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 236 | $3.5M |
| Other | HARTFORD LIFE AND ACCIDENT | 239 | $162K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 756 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.