| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS SERVICES, INC. | 2850 GOLF ROAD, SUITE 1000 ROLLING MEADOWS, IL 60008 | UNIVERSITY HEALTH ALLIANCE | $27K | — | $27K | 2.00% |
| ENHANCED BENEFITS INS SOLUTIONS3 Filed as: ENHANCED BENEFITS | 9625 MISSION GORGE ROAD SUITE B2 304 SANTEE, CA 92071 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $23K | $0 | $23K | 13.48% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 8800 EAST RAINTREE DRIVE, SUITE 250 SCOTTSDALE, AZ 85260 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $13K | $6K | $19K | 11.11% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS SERVICES, INC. | 10505 SORRENTO VALLEY ROAD SUITE 200 SAN DIEGO, CA 92121 | HAWAII DENTAL SERVICE | $2K | $0 | $2K | 1.99% |
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 | 234 | 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) | 234 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNIVERSITY HEALTH ALLIANCE | 259 | $1.4M |
| Dental | HAWAII DENTAL SERVICE | 287 | $83K |
| Vision | UNIVERSITY HEALTH ALLIANCE | 259 | $1.4M |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 209 | $173K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 209 | $173K |
| Prescription drug | UNIVERSITY HEALTH ALLIANCE | 259 | $1.4M |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 209 | $173K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 287 | — |
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.