| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 18201 VON KARMAN AVENUE, SUITE 200 IRVINE, CA 92612 | UNITEDHEALTHCARE INSURANCE COMPANY | $26K | $0 | $26K | 2.50% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD SUITE 600 GLENDALE, CA 91203 | UNITEDHEALTHCARE INSURANCE COMPANY | $0 | $3K | $3K | 0.25% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | KAISER FOUNDATION HEALTH PLAN INC | $8K | $0 | $8K | 1.99% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $1K | $1K | 1.14% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 21ST FLOOR ITASCA, IL 60143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $182 | $0 | $182 | 0.20% |
| LTC SOLUTIONS, INC.3 Filed as: LTC SOLUTIONS | UNKNOWN BREA, CA 92821 | MEDAMERICA | $1K | $0 | $1K | — |
| GALLAGHER BENEFIT SERVICES, INC.3 | 18201 VON KARMAN AVENUE, SUITE 200 IRVINE, CA 92612 | MEDAMERICA | $364 | $0 | $364 | — |
| LTC SOLUTIONS, INC.3 Filed as: LTC SOLUTIONS | UNKNOWN BREA, CA 92821 | PRUDENTIAL INSURANCE | $1K | $0 | $1K | — |
| GALLAGHER BENEFIT SERVICES, INC.3 | 18201 VON KARMAN AVENUE, SUITE 200 IRVINE, CA 92612 | PRUDENTIAL INSURANCE | $608 | $0 | $608 | — |
| LTC SOLUTIONS, INC.3 Filed as: LTC SOLUTIONS | UNKNOWN BREA, CA 92821 | MUTUAL OF OMAHA LIFE INSURANCE | $5K | $0 | $5K | — |
| GALLAGHER BENEFIT SERVICES, INC.3 | 18201 VON KARMAN AVENUE, SUITE 200 IRVINE, CA 92612 | MUTUAL OF OMAHA LIFE INSURANCE | $2K | $0 | $2K | — |
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 | 86 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 4 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 95 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 145 | $1.5M |
| Dental | DELTA DENTAL OF CALIFORNIA | 209 | $105K |
| Vision | VISION SERVICE PLAN | 91 | $14K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 102 | $91K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 102 | $91K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 102 | $91K |
| Prescription drug(3 contracts, 3 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 145 | $1.5M |
| Other(5 contracts, 5 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 107 | $94K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 209 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.