| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS. OF CA, INC. | 100585 BANC ONE DEPT 100485 PASADENA, CA 91189 | BLUE CROSS OF CALIFORNIA | $77K | $603 | $78K | 3.57% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS. OF CA, INC. | 100585 BANC ONE DEPT 100485 PASADENA, CA 91189 | KAISER FOUNDATION HEALTH PLAN INC. | $26K | — | $26K | 2.02% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS. OF CA, INC. | 100585 BANC ONE DEPT 100485 PASADENA, CA 91189 | DELTA DENTAL OF CALIFORNIA | $15K | — | $15K | 5.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS. OF CA, INC. | 100585 BANC ONE DEPT 100485 PASADENA, CA 91189 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $5K | — | $5K | 2.49% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS. OF CA, INC. | 100585 BANC ONE DEPT 100485 PASADENA, CA 91189 | ANTHEM LIFE INSURANCE COMPANY | $2K | $16 | $2K | 3.57% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS. OF CA, INC. | 100585 BANC ONE DEPT 100485 PASADENA, CA 91189 | VISION SERVICE PLAN | $2K | — | $2K | 3.98% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS. OF CA, INC. | 100585 BANC ONE DEPT 100485 PASADENA, CA 91189 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $1K | $10 | $1K | 3.57% |
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 | 538 | 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) | 545 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 290 | $3.7M |
| Dental | DELTA DENTAL OF CALIFORNIA | 441 | $305K |
| Vision | VISION SERVICE PLAN | 308 | $42K |
| Life insurance | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 454 | $37K |
| Short-term disability | ANTHEM LIFE INSURANCE COMPANY | 116 | $57K |
| Long-term disability | ANTHEM LIFE INSURANCE COMPANY | 116 | $57K |
| Prescription drug(3 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 290 | $3.7M |
| Other | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 454 | $37K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 454 | — |
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.