| 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 | $2K | $0 | $2K | 0.21% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | KAISER FOUNDATION HEALTH PLAN INC | $9K | $1K | $10K | 2.30% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $1K | $1K | 1.16% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 21ST FLOOR ITASCA, IL 60143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $148 | $0 | $148 | 0.16% |
| LTCS3 | UNKNOWN BREA, CA 92821 | MEDAMERICA | $1K | $0 | $1K | 6.09% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 18201 VON KARMAN AVENUE, SUITE 200 IRVINE, CA 92612 | MEDAMERICA | $366 | $0 | $366 | 2.03% |
| LTCS3 | UNKNOWN BREA, CA 92821 | MUTUAL OF OMAHA LIFE INSURANCE | $3K | $0 | $3K | 17.52% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 18201 VON KARMAN AVENUE, SUITE 200 IRVINE, CA 92612 | MUTUAL OF OMAHA LIFE INSURANCE | $969 | $0 | $969 | 5.84% |
| LTCS3 | UNKNOWN BREA, CA 92821 | PRUDENTIAL INSURANCE | $162 | $0 | $162 | 4.88% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 18201 VON KARMAN AVENUE, SUITE 200 IRVINE, CA 92612 | PRUDENTIAL INSURANCE | $54 | $0 | $54 | 1.63% |
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 | 97 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 100 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 66 | $1.4M |
| Dental | DELTA DENTAL OF CALIFORNIA | 195 | $82K |
| Vision | VISION SERVICE PLAN | 86 | $12K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 98 | $93K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 98 | $93K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 98 | $93K |
| Prescription drug(3 contracts, 3 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 66 | $1.4M |
| Other(5 contracts, 5 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 104 | $136K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 195 | — |
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.