| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATON INS SVCS WEST | PO BOX 101162 PASADENA, CA 91189 | AETNA LIFE INSURANCE CO. | $25K | $4K | $29K | 1.53% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA INC | 2055 GATEWAY PLACE SAN JOSE, CA 95110 | AETNA LIFE INSURANCE CO. | $16K | — | $16K | 0.86% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA INC | PO BOX 101162 PASADENA, CA 91189 | KAISER FOUNDATION HEALTH PLAN INC. | $22K | — | $22K | 2.34% |
| 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 | 2.00% |
| 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 | $2K | $2K | $4K | 2.17% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE | PO BOX 101162 PASADENA, CA 91189 | VISION SERVICE PLAN | $231 | — | $231 | 0.79% |
| 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 | $524 | $1 | $525 | 2.08% |
| 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 | $292 | — | $292 | 1.55% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | 3300 EXECUTIVE PKWY STE 300 SAN RAMON, CA 94583 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $7 | — | $7 | 0.04% |
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 | 692 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 226 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 920 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA LIFE INSURANCE CO. | 228 | $2.8M |
| Dental | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 320 | $247K |
| Vision | VISION SERVICE PLAN | 244 | $29K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 573 | $184K |
| Short-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 573 | $203K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 573 | $184K |
| Prescription drug(2 contracts, 2 carriers) | AETNA LIFE INSURANCE CO. | 228 | $2.8M |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 573 | $209K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 573 | — |
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.