| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 5TH FLOOR ROLLING MEADOWS, IL 60008 | BLUE CROSS OF CALIFORNIA | $76K | $250 | $77K | 5.04% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 160 WEST SANTA CLARA STREET SUITE 300 SAN JOSE, CA 95113 | KAISER FOUNDATION HEALTH PLAN INC | $13K | — | $13K | 4.27% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | KAISER FOUNDATION HEALTH PLAN INC | — | $378 | $378 | 0.13% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $17K | $17K | 6.46% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 1 ALMADEN BOULEVARD, SUITE 960 SAN JOSE, CA 95113 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $15K | $0 | $15K | 5.75% |
| GALLAGHER BENEFIT SERVICES, INC.5 | 160 WEST SANTA CLARA STREET SUITE 300 SAN JOSE, CA 95113 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $4K | $4K | 1.52% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 1 ALMADEN BOULEVARD, SUITE 960 SAN JOSE, CA 95113 | TRANSAMERICA LIFE INSURANCE COMPANY | $989 | $0 | $989 | 9.72% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH AND BENEFITS, LLC. | 4 EMBARCADERO CENTER, SUITE 40 SAN FRANCISCO, CA 94111 | TRANSAMERICA LIFE INSURANCE COMPANY | $705 | $0 | $705 | 6.93% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 160 WEST SANTA CLARA STREET SUITE 300 SAN JOSE, CA 95113 | CALIFORNIA DENTAL NETWORK, INC. | $452 | $0 | $452 | 10.00% |
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 | 187 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 188 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 256 | $1.8M |
| Dental(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 133 | $273K |
| Vision | BLUE CROSS OF CALIFORNIA | 256 | $1.5M |
| Life insurance(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 133 | $279K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 133 | $269K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 133 | $269K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 256 | $1.8M |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 133 | $279K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 256 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.