| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA, INC. | 18101 VON KARMAN AVE, STE 600 IRVINE, CA 92612 | CALIFORNIA PHYSICIANS SERVICE BLUE SHIELD OF CALIFORNIA | $123K | $128 | $123K | 2.25% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF WISCONSIN INC | PO BOX 1650 MILWAUKEE, WI 53201 | UNITY HEALTH PLANS INSURANCE CORPORATION | $73K | — | $73K | 2.22% |
| 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 | $19K | — | $19K | 2.20% |
| 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 INSURANCE SVCS OF CA | PO BOX 101162 PASADENA, CA 91189 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $4K | — | $4K | 10.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA INC | 801 S FIGUEROA ST, STE 700 LOS ANGELES, CA 90017 | CONCERN | $843 | — | $843 | 5.00% |
| 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 | 589 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 31 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 64 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 684 | 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 | 636 | $9.7M |
| Vision | VISION SERVICE PLAN | 512 | $99K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 661 | $458K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 661 | $264K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 661 | $264K |
| Prescription drug(3 contracts, 3 carriers) | CALIFORNIA PHYSICIANS SERVICE BLUE SHIELD OF CALIFORNIA | 636 | $9.6M |
| Other(4 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 661 | $484K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 661 | — |
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.