| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MERCER HEALTH AND BENEFITS, LLC3 | 155 N WACKER DR STE 1500 CHICAGO, IL 606061710 | KAISER FOUNDATION HEALTH PLAN INC. | $5K | — | $5K | 0.24% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC. | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $26K | — | $26K | 2.20% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC. | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $12K | — | $12K | 1.82% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC. | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | — | $4K | 1.86% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC | PO BOX 741909 LOCKBOX 741909 ATLANTA, GA 303741909 | RELIASTAR LIFE INSURANCE COMPANY | $3K | — | $3K | 1.51% |
| INTERCARE INSURANCE SOLUTIONS, INC.3 Filed as: INTERCARE INSURANCE SOLUTIONS, INC | 4371 LATHAM ST STE 101 RIVERSIDE, CA 92501 | KAISER FOUNDATION HEALTH PLAN INC. | $1K | — | $1K | 0.62% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CALIFORNIA INS | PO BOX 2158 RIVERSIDE, CA 925162158 | KAISER FOUNDATION HEALTH PLAN INC. | — | $441 | $441 | 0.21% |
| ACS HUMAN RESOURCE SOLUTIONS, INC.3 Filed as: ACS HUMAN RESOURCES SOLUTIONS INC. | PO BOX 202617 DALLAS, TX 75230 | KAISER FOUNDATION HEALTH PLAN INC. | $8K | — | $8K | 5.61% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | KAISER FOUNDATION HEALTH PLAN INC. | $528 | — | $528 | 0.35% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC. | COMMISSION LOCKBOX 28852 P.O. BOX 28852 NEW YORK, NY 10087 | HYATT LEGAL PLANS | $12K | — | $12K | 11.93% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE, INC. | D/B/A WATSON WYATT WORLDWIDE, INC. LOCKBOX #741909, P.O. BOX 741909 ATLANTA, GA 303741909 | HYATT LEGAL PLANS | — | $2K | $2K | 2.00% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | HYATT LEGAL PLANS | — | $337 | $337 | 0.34% |
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 | 3,501 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 149 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 3,650 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 359 | $2.5M |
| Dental | AETNA LIFE INSURANCE COMPANY | 7 | $33K |
| Vision(2 contracts, 2 carriers) | VISION SERVICE PLAN | 3,202 | $855K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 3,598 | $1.2M |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 3,603 | $653K |
| Prescription drug(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC. | 37 | $357K |
| Other(6 contracts, 5 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 5,480 | $1.8M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,480 | — |
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.