| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS | 18101 VON KARMAN AVE, STE 600 IRVINE, CA 92612 | CALIFORNIA PHYSICIANS SERVICE BLUE SHIELD OF CALIFORNIA | $138K | $5K | $143K | 3.10% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WISCONSIN INC | 2323 N MAYFAIR RD, STE 600 MILWAUKEE, WI 53226 | UNITY HEALTH PLANS INSURANCE CORPORATION | $79K | — | $79K | 3.38% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA INC | 2055 GATEWAY PL, STE 450 SAN JOSE, CA 95110 | KAISER FOUNDATION HEALTH PLAN INC | $45K | — | $45K | 3.78% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA INC | 525 MARKET ST, STE 3400 SAN FRANCISCO, CA 94105 | HARTFORD LIFE AND ACCIDENT | $8K | $12K | $20K | 3.66% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA INC | PO BOX 101162 PASADENA, CA 91189 | VISION SERVICE PLAN | $3K | — | $3K | 2.48% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WISCONSIN INC | 2323 NORTH MAYFAIR RD, STE 600 MILWAUKEE, WI 53226 | HARTFORD LIFE AND ACCIDENT | — | $463 | $463 | 1.75% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS | 801 S FIGUEROA ST, STE 700 LOS ANGELES, CA 90017 | CONCERN | $975 | — | $975 | 5.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA INC | 2055 GATEWAY PL, STE 450 SAN JOSE, CA 95110 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $2K | — | $2K | 10.64% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK INC | 200 LIBERTY ST NEW YORK, NY 10201 | FEDERAL INSURANCE COMPANY | $2K | — | $2K | 25.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA INC | 2055 GATEWAY PL STE 450 SAN JOSE, CA 95110 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $570 | — | $570 | 10.70% |
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 | 589 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 8 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 605 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 5 carriers) | CALIFORNIA PHYSICIANS SERVICE BLUE SHIELD OF CALIFORNIA | 559 | $8.2M |
| Dental(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 2 | $19K |
| Vision | VISION SERVICE PLAN | 545 | $108K |
| Life insurance(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 1,385 | $558K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 1,385 | $552K |
| Long-term disability(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 1,385 | $558K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE BLUE SHIELD OF CALIFORNIA | 559 | $6.9M |
| Other(6 contracts, 5 carriers) | HARTFORD LIFE AND ACCIDENT | 1,385 | $631K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,385 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.