| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS OF CA INC. | 2010 MAIN STREET, SUITE 1050 IRVINE, CA 92614 | CALIFORNIA PHYSICIANS SERVICE/BLUE SHIELD OF CALIFORNIA | — | $243K | $243K | 5.89% |
| ASSUREDPARTNERS3 Filed as: VOLUNTARY BENEIFT ADVISORS | 2400 MAIN STREET, SUITE 200 IRVINE, CA 92614 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $70K | $20K | $90K | 24.59% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS OF CA INC. | 2010 MAIN STREET, SUITE 1050 IRVINE, CT 92612 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $16K | $2K | $18K | 4.81% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF HOUSTON, LLC | 6200 SAVOY, SUITE 345 HOUSTON, TX 77036 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $9K | $343 | $9K | 2.47% |
| ASSUREDPARTNERS3 Filed as: VOLUNTARY BENEIFT ADVISORS | 2400 MAIN STREET, SUITE 200 IRVINE, CA 92614 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $109K | $21K | $130K | 38.51% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS OF CA INC. | 2010 MAIN STREET, SUITE 1050 IRVINE, CA 92612 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $19K | $2K | $21K | 6.20% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF HOUSTON, LLC | 6200 SAVOY, SUITE 345 HOUSTON, TX 77036 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $9K | $312 | $9K | 2.75% |
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 | 1,481 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,486 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA PHYSICIANS SERVICE/BLUE SHIELD OF CALIFORNIA | 1,367 | $4.1M |
| Dental | CALIFORNIA PHYSICIANS SERVICE/BLUE SHIELD OF CALIFORNIA | 1,367 | $4.1M |
| Vision | CALIFORNIA PHYSICIANS SERVICE/BLUE SHIELD OF CALIFORNIA | 1,367 | $4.1M |
| Life insurance(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE/BLUE SHIELD OF CALIFORNIA | 1,367 | $4.5M |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 933 | $337K |
| Prescription drug | CALIFORNIA PHYSICIANS SERVICE/BLUE SHIELD OF CALIFORNIA | 1,367 | $4.1M |
| Other(3 contracts, 3 carriers) | CALIFORNIA PHYSICIANS SERVICE/BLUE SHIELD OF CALIFORNIA | 1,718 | $4.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,718 | — |
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.