| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA INC | 525 MARKET ST, STE 3400 SAN FRANCISCO, CA 94105 | UNITED HEALTHCARE INSURANCE COMPANY | $134K | — | $134K | 4.99% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA INC | 2055 GATEWAY PL, STE 450 SAN JOSE, CA 95110 | DELTA DENTAL OF NEW YORK | $8K | — | $8K | 3.80% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NY | 200 LIBERTY ST NEW YORK, NY 10281 | DELTA DENTAL OF NEW YORK | $1K | — | $1K | 0.70% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS OF CA | 525 MARKET ST, STE 3400 SAN FRANCISCO, CA 94105 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $9K | $1K | $10K | 9.84% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA INC | 2055 GATEWAY PL, STE 450 SAN JOSE, CA 95110 | KAISER FOUNDATION HEALTH PLAN INC | $3K | — | $3K | 4.34% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA INC | PO BOX 101162 PASADENA, CA 91189 | VISION SERVICE PLAN | $1K | — | $1K | 5.75% |
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 | 150 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 156 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 314 | $2.8M |
| Dental | DELTA DENTAL OF NEW YORK | 140 | $205K |
| Vision | VISION SERVICE PLAN | 121 | $18K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 134 | $106K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 134 | $106K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 134 | $106K |
| Other | RELIANCE STANDARD LIFE INSURANCE COMPANY | 134 | $106K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 314 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.