| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 500 NORTH SANTA FE VISALIA, CA 93292 | CALIFORNIA PHYSICIANS SERVICE | $77K | $14K | $91K | 1.18% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | METROPOLITAN LIFE INSURANCE COMPANY | $37K | $10K | $47K | 7.21% |
| LIAZON BENEFITS INC3 Filed as: LIAZON BENEFITS, INC. | 199 SCOTT STREET, 8TH FLOOR BUFFALO, NY 14204 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $37K | $37K | 5.69% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $64K | $0 | $64K | 14.18% |
| LIAZON BENEFITS INC3 Filed as: LIAZON BENEFITS, INC. | 199 SCOTT STREET, 8TH FLOOR BUFFALO, NY 14204 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $21K | $0 | $21K | 4.73% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 400 MIDLANTIC DRIVE, SUITE 300 MOUNT LAUREL, NJ 08054 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $1K | $0 | $1K | 0.30% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 71542 CHICAGO, IL 60694 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $26K | $0 | $26K | 10.74% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $23K | $0 | $23K | 9.51% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, SUITE 1000 ROLLING MEADOWS, IL 60008 | VISION SERVICE PLAN | $7K | $0 | $7K | 10.00% |
| LIAZON BENEFITS INC3 Filed as: LIAZON BENEFITS, INC. | 199 SCOTT STREET BUFFALO, NY 14204 | VISION SERVICE PLAN | $4K | $0 | $4K | 5.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $3K | $765 | $4K | 6.37% |
| LIAZON BENEFITS INC3 Filed as: LIAZON BENEFITS, INC. | 199 SCOTT STREET, 8TH FLOOR BUFFALO, NY 14204 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $0 | $3K | $3K | 5.03% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 100 MATSONFORD ROAD 4 RADNOR CORP. CENTER, SUITE 510 RADNOR, PA 19087 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $0 | $71 | $71 | 0.12% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE ITASCA, IL 60143 | U.S. BEHAVIORAL HEALTH PLAN, CALIFORNIA DBA OPTUM | $3K | $0 | $3K | 14.95% |
| CUSTOM BENEFITS PROGRAMS3 Filed as: CUSTOM BENEFITS PROGRAMS, INC. | 897 12TH STREET HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $6 | $132 | $138 | 4.44% |
| LOUIS R FAIOLA3 Filed as: LOUIS JOSEPH PANTALONE | 897 12TH STREET HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $73 | $0 | $73 | 2.35% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP, INC. | 80 SOUTH 8TH STREET, SUITE 700 MINNEAPOLIS, MN 55402 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $32 | $0 | $32 | 1.03% |
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 | 674 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 16 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 695 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA PHYSICIANS SERVICE | 1,178 | $7.7M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 759 | $715K |
| Vision(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 1,178 | $7.8M |
| Life insurance(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 512 | $455K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 512 | $452K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 512 | $452K |
| Prescription drug | CALIFORNIA PHYSICIANS SERVICE | 1,178 | $7.7M |
| Other(4 contracts, 4 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 676 | $715K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,178 | — |
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."
No prospect flags tripped on this filing.