| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS. SVCS. | PO BOX 28852 NEW YORK, IN 10087 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $349K | $70K | $420K | 9.38% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $856 | $856 | 0.02% |
| ALLIANT INSURANCE SERVICES, INC.3 | 2185 NORTH CALIFORNIA BOULEVARD WALNUT CREEK, CA 94596 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $29K | $0 | $29K | 8.95% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS. SVCS. | PO BOX 28852 NEW YORK, NY 10087 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $797 | — | $797 | 0.25% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NE, INC. | 200 LIBERTY STREET, 7TH FLOOR NEW YORK, NY 10281 | ZURICH AMERICAN INSURANCE COMPANY | $26K | $0 | $26K | 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 | 4,149 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 80 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 60 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 4,289 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 675 | $5.6M |
| Dental(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 23 | $467K |
| Vision | HAWAII MEDICAL SERVICE ASSOCIATION | 23 | $147K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 4,479 | $4.5M |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 4,479 | $4.5M |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 4,479 | $4.5M |
| Prescription drug(4 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 675 | $5.6M |
| Other(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 8,115 | $4.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 8,115 | — |
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."
No prospect flags tripped on this filing.