| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS HRH | 18101 VON KARMAN AVE, STE 600 IRVINE, CA 92612 | CALIFORNIA PHYSICIANS SERVICE BLUE SHIELD OF CALIFORNIA | $170K | $120 | $170K | 3.15% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WISCONSIN INC | PO BOX 1650 MILWAUKEE, WI 53201 | UNITY HEALTH PLANS INSURANCE CORPORATION | $79K | — | $79K | 2.76% |
| 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 | $31K | — | $31K | 3.19% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA INC | PO BOX 101162 PASADENA, CA 91189 | HARTFORD LIFE AND ACCIDENT | — | $7K | $7K | 1.68% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA INC | PO BOX 101162 PASADENA, CA 91189 | VISION SERVICE PLAN | $3K | — | $3K | 2.59% |
| 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 | $3K | — | $3K | 10.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS | 801 S FIGUEROA ST, STE 700 LOS ANGELES, CA 90017 | CONCERN | $920 | — | $920 | 5.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS OF CA | PO BOX 101162 PASADENA, CA 91189 | HARTFORD LIFE AND ACCIDENT | — | $434 | $434 | 2.38% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK | 200 LIBERTY STREET 7TH FLOOR NEW YORK, NY 10281 | FEDERAL INSURANCE COMPANY | $2K | — | $2K | 25.00% |
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 | 576 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 17 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 13 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 606 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | CALIFORNIA PHYSICIANS SERVICE BLUE SHIELD OF CALIFORNIA | 766 | $9.3M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1 | $32K |
| Vision | VISION SERVICE PLAN | 514 | $97K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 650 | $410K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 650 | $410K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 650 | $410K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE BLUE SHIELD OF CALIFORNIA | 766 | $8.3M |
| Other(5 contracts, 4 carriers) | HARTFORD LIFE AND ACCIDENT | 650 | $488K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 766 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.