| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PACIFIC RESOURCES BENEFITS ADVISORS | 21300 VICTORY BLVD SUITE 635 WOODLAND HILLS, CA 91367 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $224K | $0 | $224K | 1.32% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PACIFIC RESOURCES BENEFIT ADVISORS | 21300 VICTORY BLVD SUITE 635 WOODLAND, CA 91367 | LIBERTY MUTUAL ASSURANCE COMPANY OF BOSTON | $188K | $0 | $188K | 1.74% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PACIFIC RESOURCES BENEFITS ADVISORS | 75 STATE ST., SUITE 1710 SUITE 635 BOSTON, MA 02109 | VISION SERVICE PLAN | — | $65K | $65K | 2.00% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PACIFIC RESOURCES BENEFITS ADVISORS | 21300 VICTORY BLVD SUITE 635 WOODLAND HILLS, CA 91367 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $4K | $0 | $4K | 1.29% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 606036115 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $10K | $10K | 8.63% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PACIFIC RESOURCES BENEFITS ADVISORS | 21300 VICTORY BLVD SUITE 635 WOODLAND HILLS, CA 91367 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 1.35% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| LIBERTY MUTUAL ASSURANCE COMPANY OF EIN 04-6076039 NONE | Other services; Other fees Service code 49 | BOSTON 175 BERKELEY STREET BOSTON, MA 02116 | $1.2M |
| UNITED BEHAVIORAL HEALTH DBA OPTUM EIN 94-2649097 NONE | Plan Administrator; Claims processing; Other services; Other fees Service code 12 | P.O. BOX 39000 SAN FRANCISCO, CA 941395897 | $731K |
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 | 28,361 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1,203 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 5,863 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 35,427 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 22,993 | $3.3M |
| Life insurance(2 contracts) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 47,032 | $17.3M |
| Long-term disability | LIBERTY MUTUAL ASSURANCE COMPANY OF BOSTON | 27,037 | $10.8M |
| Other(3 contracts) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 47,032 | $17.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 47,032 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.