| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 10940 WHITE ROCK ROAD, 2ND FLOOR RANCHO CORDOVA, CA 95670 | CALIFORNIA PHYSICIANS SERVICE | $134K | $269 | $135K | 1.52% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 21250 HAWTHORNE BOULEVARD SUITE 600 TORRANCE, CA 90503 | DELTA DENTAL OF CALIFORNIA | $34K | — | $34K | 4.57% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | PO BOX 3900 SAN FRANCISCO, CA 94139 | AETNA LIFE INSURANCE COMPANY | $44K | $3K | $47K | 10.44% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 15303 VENTURA BOULEVARD SUITE 700 SHERMAN OAKS, CA 91403 | AETNA LIFE INSURANCE COMPANY | — | $67 | $67 | 0.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 21250 HAWTHORNE BOULEVARD SUITE 600 TORRANCE, CA 90503 | VISION SERVICE PLAN | $3K | — | $3K | 2.65% |
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 | 853 | 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) | 853 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 1,590 | $9.3M |
| Dental | DELTA DENTAL OF CALIFORNIA | 1,578 | $747K |
| Vision(2 contracts, 2 carriers) | VISION SERVICE PLAN | 841 | $116K |
| Life insurance | AETNA LIFE INSURANCE COMPANY | 853 | $449K |
| Short-term disability | AETNA LIFE INSURANCE COMPANY | 853 | $449K |
| Long-term disability | AETNA LIFE INSURANCE COMPANY | 853 | $449K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 1,590 | $9.3M |
| Other(3 contracts, 3 carriers) | AETNA LIFE INSURANCE COMPANY | 853 | $462K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,590 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.