| 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 | $72K | $3K | $75K | 5.31% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 160 WEST SANTA CLARA STREET SUITE 300 SAN JOSE, CA 95113 | KAISER FOUNDATION HEALTH PLAN INC | $8K | $0 | $8K | 4.07% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | KAISER FOUNDATION HEALTH PLAN INC | $0 | $61 | $61 | 0.03% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 1 ALMADEN BOULEVARD, SUITE 960 SAN JOSE, CA 95113 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $11K | $0 | $11K | 5.63% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $7K | $7K | 3.74% |
| GALLAGHER BENEFIT SERVICES, INC.5 | 160 WEST SANTA CLARA STREET SUITE 300 SAN JOSE, CA 95113 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $2K | $2K | 1.30% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 160 WEST SANTA CLARA STREET SUITE 300 SAN JOSE, CA 95113 | CALIFORNIA DENTAL NETWORK, INC. | $468 | $0 | $468 | 10.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 | ONE ALMADEN BOULEVARD, SUITE 960 SAN JOSE, CA 95113 | TRANSAMERICA LIFE INSURANCE COMPANY | $424 | $0 | $424 | 9.70% |
| 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 | $276 | $0 | $276 | 6.32% |
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 | 141 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 143 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 188 | $1.6M |
| Dental(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 141 | $195K |
| Vision | BLUE CROSS OF CALIFORNIA | 188 | $1.4M |
| Life insurance(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 141 | $194K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 141 | $190K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 188 | $1.6M |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 141 | $194K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 188 | — |
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.