| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SRVS WEST | 2010 MAIN ST IRVINE, CA 92614 | AETNA LIFE INSURANCE CO. | $78K | — | $78K | 4.41% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | PO BOX 101162 PASADENA, CA 91189 | AETNA LIFE INSURANCE CO. | $6K | — | $6K | 0.36% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SRVS WEST | 2010 MAIN ST IRVINE, CA 92614 | AETNA HEALTH, INC. | $5K | — | $5K | 4.32% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | PO BOX 101162 PASADENA, CA 91189 | AETNA HEALTH, INC. | $528 | — | $528 | 0.48% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | 2055 GATEWAY PL STE 430 SAN JOSE, CA 95110 | KAISER FOUNDATION HEALTH PLAN INC | $4K | — | $4K | 4.11% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE | PO BOX 101162 PASADENA, CA 91189 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | $110 | $6K | 12.38% |
| MONTAGE INSURANCE SOLUTIONS3 | 24005 VENTURA BLVD CALABASAS, CA 91302 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $1K | $1K | 2.72% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE | PO BOX 101162 PASADENA, CA 91189 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $67 | $3K | 12.39% |
| MONTAGE INSURANCE SOLUTIONS3 | 24005 VENTURA BLVD CALABASAS, CA 91302 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $825 | $825 | 3.73% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | 525 MARKET ST STE 3400 SAN FRANCISCO, CA 94105 | AMERITAS LIFE INSURANCE CORP. | $2K | — | $2K | 10.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NORTH CAROLINA INC | HEARST TOWER 214 N TRYON ST STE 2500 CHARLOTTE, NC 28202 | AMERITAS LIFE INSURANCE CORP. | — | $678 | $678 | 3.28% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE | PO BOX 101162 PASADENA, CA 91189 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $52 | $2K | 12.28% |
| MONTAGE INSURANCE SOLUTIONS3 | 24005 VENTURA BLVD CALABASAS, CA 91302 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $677 | $677 | 3.81% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE | PO BOX 101162 PASADENA, CA 91189 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $451 | $12 | $463 | 12.02% |
| MONTAGE INSURANCE SOLUTIONS3 | 24005 VENTURA BLVD CALABASAS, CA 91302 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $146 | $146 | 3.79% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SVCS. | 580 CALIFORNIA ST, #1300 SAN FRANCISCO, CA 94104 | FEDERAL INSURANCE COMPANY | $518 | $78 | $596 | 17.28% |
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 | 148 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 4 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 153 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | AETNA LIFE INSURANCE CO. | 272 | $2.0M |
| Dental | AETNA LIFE INSURANCE CO. | 272 | $1.8M |
| Vision | AMERITAS LIFE INSURANCE CORP. | 283 | $21K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 149 | $18K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 149 | $22K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 149 | $49K |
| Prescription drug(2 contracts, 2 carriers) | AETNA LIFE INSURANCE CO. | 272 | $1.9M |
| Other(3 contracts, 3 carriers) | MANAGED HEALTH NETWORK | 248 | $15K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 283 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.