| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA INC | 2055 GATEWAY PLACE, STE 400 SAN JOSE, CA 95110 | AETNA LIFE INSURANCE CO. | $88K | — | $88K | 5.45% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA INC | PO BOX 101162 PASADENA, CA 91189 | KAISER FOUNDATION HEALTH PLAN INC. | $40K | — | $40K | 3.84% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA INC | 2055 GATEWAY PLACE SUITE 400 SAN JOSE, CA 95110 | AETNA HEALTH, INC | $10K | — | $10K | 5.48% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA, INC. | PO BOX 101162 PASADENA, CA 91189 | KAISER FOUNDATION HEALTH PLAN OF COLORADO | $5K | $55 | $5K | 5.15% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA, INC. | LOCKBOX 100485 PASADENA, CA 91189 | KAISER FOUNDATION HEALTH PLAN OF MID-ATLANTIC | $4K | — | $4K | 6.45% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE | 4250 EXECUTIVE SQUARE SUITE 900 LA JOLLA, CA 92037 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 10.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | PO BOX 101162 PASADENA, CA 91189 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $332 | $2K | 6.43% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE | PO BOX 101162 PASADENA, CA 91189 | VISION SERVICE PLAN | $222 | — | $222 | 4.90% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | PO BOX 101162 PASADENA, CA 91189 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $51 | — | $51 | 2.06% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | PO BOX 101162 PASADENA, CA 91189 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $25 | — | $25 | 1.53% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 3000 EXECUTIVE PKWY STE 300 SAN RAMON, CA 94583 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.06% |
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 | 957 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 51 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 348 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,356 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 5 carriers) | AETNA LIFE INSURANCE CO. | 177 | $3.0M |
| Dental | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 309 | $53K |
| Vision | VISION SERVICE PLAN | 216 | $5K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 196 | $28K |
| Short-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 196 | $30K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 196 | $28K |
| Prescription drug(5 contracts, 5 carriers) | AETNA LIFE INSURANCE CO. | 177 | $3.0M |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 196 | $31K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 309 | — |
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.