| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA INC | PO BOX 101162 PASADENA, CA 91189 | BLUE CROSS OF CALIFORNIA | $97K | — | $97K | 4.92% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA INC. | BANC ONE DEPT 100485 PASADENA, CA 91189 | ANTHEM BLUE BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $16K | — | $16K | 8.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA INC | 525 MARKET ST, STE 3400 SAN FRANCISCO, CA 94105 | SYMETRA LIFE INSURANCE COMPANY | $10K | — | $10K | 15.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA INC | BANC ONE DEPT 100485 PASADENA, CA 91189 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 5.71% |
| JERALD J REED3 | 5121 FEATHER WAY ANTIOCH, CA 94531 | AFLAC | $2K | $133 | $2K | 8.19% |
| GRAND GUILLORY3 | 5116 FURLONG WAY ANTIOCH, CA 94531 | AFLAC | $608 | $53 | $661 | 2.30% |
| VARIOUS OTHER AGENTS & BROKERS*3 Filed as: VARIOUS OTHER AGENTS & BROKERS | UNKNOWN OAKLAND, CA 94606 | AFLAC | $413 | $117 | $530 | 1.84% |
| JOHN HARRIS JR3 | 4400 HORNER ST UNION CITY, CA 94587 | AFLAC | $325 | $131 | $456 | 1.59% |
| JUSTIN M REYNOLDS3 Filed as: JUSTIN REYNOLDS | 8433 ENTERPRISE CIR STE 100 LAKEWOOD RANCH, FL 34202 | AFLAC | $226 | $64 | $290 | 1.01% |
| JONATHAN D PAYNE3 | 110 HASLEMERE CT LAFAYETTE, CA 94549 | AFLAC | $260 | — | $260 | 0.90% |
| CYNTHIA VALDIVIA3 | 235 SUNSPRING CT PLEASANT HILL, CA 94523 | AFLAC | $143 | — | $143 | 0.50% |
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 | 320 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 322 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 1 | $2.0M |
| Dental | ANTHEM BLUE BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 284 | $198K |
| Vision | STANDARD INSURANCE COMPANY | 211 | $30K |
| Life insurance | SYMETRA LIFE INSURANCE COMPANY | 315 | $65K |
| Short-term disability | AFLAC | 26 | $29K |
| Long-term disability | SYMETRA LIFE INSURANCE COMPANY | 315 | $65K |
| Other(2 contracts, 2 carriers) | SYMETRA LIFE INSURANCE COMPANY | 315 | $93K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 315 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.