| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | 2010 MAIN ST., STE. 1050 IRVINE, CA 92614 | CALIFORNIA PHYSICIANS' SERVICE | — | $111K | $111K | 5.23% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | PO BOX 101162 PASADENA, CA 91189 | DELTA DENTAL OF CALIFORNIA | $14K | — | $14K | 10.00% |
| 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. | $5K | — | $5K | 4.24% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE SVCS | PO BOX 101162 PASADENA, CA 91189 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $10K | — | $10K | 17.31% |
| DANONE SIMPSON INSURANCE SERVICES3 Filed as: DANONE SIMPSON INSURANCE SVCS LLC | 24005 VENTURA BLVD CALABASAS, CA 91302 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $254 | $254 | 0.42% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | PO BOX 101162 PASADENA, CA 91189 | VISION SERVICE PLAN | $1K | — | $1K | 4.59% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE SVCS | PO BOX 101162 PASADENA, CA 91189 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | — | $5K | 17.47% |
| DANONE SIMPSON INSURANCE SERVICES3 Filed as: DANONE SIMPSON INSURANCE SVCS LLC | 24005 VENTURA BLVD CALABASAS, CA 91302 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $113 | $113 | 0.43% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE SVCS | PO BOX 101162 PASADENA, CA 91189 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | — | $4K | 17.07% |
| DANONE SIMPSON INSURANCE SERVICES3 Filed as: DANONE SIMPSON INSURANCE SVCS LLC | 24005 VENTURA BLVD CALABASAS, CA 91302 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $92 | $92 | 0.36% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON WEST INC | PO BOX 101162 PASADENA, CA 91189 | STANDARD INSURANCE COMPANY | $4K | — | $4K | 52.68% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE SVCS | PO BOX 101162 PASADENA, CA 91189 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $871 | — | $871 | 17.56% |
| DANONE SIMPSON INSURANCE SERVICES3 Filed as: DANONE SIMPSON INSURANCE SVCS LLC | 24005 VENTURA BLVD CALABASAS, CA 91302 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $19 | $19 | 0.38% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SVCS | 90 NEW MONTGOMERY ST 250 SAN FRANCISCO, CA 94105 | FEDERAL INSURANCE COMPANY | $560 | $82 | $642 | 17.20% |
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 | 180 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 5 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 187 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 290 | $2.2M |
| Dental | DELTA DENTAL OF CALIFORNIA | 319 | $144K |
| Vision | VISION SERVICE PLAN | 152 | $31K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 180 | $26K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 180 | $26K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 180 | $60K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 290 | $2.2M |
| Other(5 contracts, 4 carriers) | TELUS HEALTH (US) LTD. | 289 | $29K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 319 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.