| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC | LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | MINNESOTA LIFE INSURANCE COMPANY | — | $37K | $37K | 2.30% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE, INC. | LOCKBOX #28852 PO BOX 28852 NEW YORK, NY 10087 | BLUE CROSS OF CALIFORNIA | $37K | — | $37K | 2.76% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC | 4565 PAYSHERE CIRCLE CHICAGO, IL 60674 | BLUE CROSS OF CALIFORNIA | $23K | — | $23K | 1.74% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC | LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | MINNESOTA LIFE INSURANCE COMPANY | — | $29K | $29K | 2.30% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC. | LOCKBOX #741909 PO BOX 741909 ATLANTA, GA 303741909 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | — | $13K | $13K | 1.50% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC. | LOCKBOX #9102 PO BOX 8500 PHILADELPHIA, PA 191789102 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | — | $7K | $7K | 0.80% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE, INC. | P.O BOX 741909 ATLANTA, GA 30374 | HYATT LEGAL PLANS, INC. | $17K | $6K | $22K | 7.76% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WASTSON DELAWARE INC. | PO BOX 28852 NEW YORK, NY 10087 | HYATT LEGAL PLANS, INC. | $12K | $31 | $12K | 4.20% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC | LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | MINNESOTA LIFE INSURANCE COMPANY | — | $6K | $6K | 2.23% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC | LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | MINNESOTA LIFE INSURANCE COMPANY | — | $703 | $703 | 2.30% |
| MCCAREY INC3 | 121A N LOOP DRIVE CAMARILLO, CA 93010 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $159 | — | $159 | 10.96% |
| R & B ENROLLMENT SERVICES INC3 Filed as: R&B ENROLLMENT SERVICES INC. | PO BOX 3216 CRESTLINE, CA 92325 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $45 | — | $45 | 3.10% |
| CALIFORNIA INSURANCE ADVOCATES INC3 | 41960 AVENIDA DE ANITA TEMECULA, CA 92592 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $32 | — | $32 | 2.21% |
| ANDREA MARIE TIERCE3 | 2204 PLEASANTWOOD LANE ESCONDIDO, CA 92026 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $32 | — | $32 | 2.21% |
| MAGNONE FINANCIAL SERVICES CORP3 Filed as: MAGNONE FINACIAL SERICES CROP | 3151 OUTRIGGER AVENUE VENTURA, CA 93001 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.34% |
| WILLIAM KYZER3 | PO BOX 8213 HERMITAGE, TN 37076 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.21% |
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 | 12,903 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 12,910 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 506 | $90K |
| Dental(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 16,744 | $9.3M |
| Vision | VISION SERVICE PLAN | 8,305 | $1.2M |
| Life insurance(5 contracts, 2 carriers) | MINNESOTA LIFE INSURANCE COMPANY | 12,829 | $3.2M |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 6 | $2K |
| Long-term disability | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 11,169 | $851K |
| Other(6 contracts, 5 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 11,924 | $1.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 16,744 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.