| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | PO BOX 101162 PASADENA, CA 91189 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $40K | $40K | 1.55% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $908 | $908 | 0.03% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST, INC | 10 STATE HOUSE SQUARE, 11TH FLOOR HARTFORD, CT 06103 | RELIASTAR LIFE INSURANCE COMPANY | $97K | — | $97K | 15.88% |
| BENE RE LLC3 | 5217 MONROE ST STE B TOLEDO, OH 43623 | RELIASTAR LIFE INSURANCE COMPANY | — | $33K | $33K | 5.41% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST, INC | 100 BANK ST STE 500 BURLINGTON, VT 05401 | KAISER FOUNDATION HEALTH PLAN INC | $3K | — | $3K | 4.66% |
| CONNER STRONG & BUCKELEW3 Filed as: CONNER STRONG & BUCKELEW COMPANIES | 401 ROUTE 73 N STE 300 MARLTON, NJ 08053 | KAISER FOUNDATION HEALTH PLAN INC | $168 | — | $168 | 0.28% |
| REUBEN WARNER ASSOCIATES, INC.3 | 1655 RICHMOND AVENEUE STATEN ISLAND, NY 10314 | BERKLEY LIFE AND HEALTH INSURANCE COMPANY | — | $4K | $4K | 20.00% |
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 | 4,904 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 28 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 62 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 4,994 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 21 | $61K |
| Vision | VISION SERVICE PLAN | 3,616 | $578K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 5,065 | $2.6M |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 5,065 | $2.6M |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 21 | $61K |
| Other(3 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 5,065 | $3.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,065 | — |
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.