| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 | LOCKBOX 28852 P.O. BOX 28852 NEW YORK, NY 100878852 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $161K | — | $161K | 8.09% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SERVICES OF CA INC | WILLIS LOCKBOX 100485 BANC ONE DEPT 100485 PASADENA, CA 911890485 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $73K | — | $73K | 3.64% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SERVICES OF CA INC | WILLIS LOCKBOX 100485 BLDG 6, SUITE JP MORGAN LOS ANGELES, CA 90065 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $16K | — | $16K | 0.79% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $708 | $708 | 0.04% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVE, SUITE 1100 CHICAGO, ID 606036115 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $132 | $132 | 0.01% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | 801 SOUTH FIGUEROA STREET SUITE 800 LOS ANGELES, CA 90017 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | — | $463 | $463 | 0.05% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA, INC. | PO BOX 101162 PASADENA, CA 91189 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $17K | — | $17K | 8.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA INC | PO BOX 101162 PASADENA, CA 91189 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $12K | — | $12K | 10.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK INC | 200 LIBERTY STREET 7TH FLOOR NEW YORK, NY 10281 | ZURICH AMERICAN INSURANCE COMPANY | $16K | — | $16K | 25.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA INC | PO BOX 101162 PASADENA, CA 91189 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $667 | — | $667 | 8.00% |
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 | 3,130 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 837 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 82 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 4,049 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(7 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 877 | $5.6M |
| Dental(3 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 18 | $280K |
| Vision(2 contracts) | HMSA | 18 | $73K |
| Life insurance(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 3,165 | $2.0M |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 3,165 | $2.0M |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 3,165 | $2.0M |
| Prescription drug(5 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 877 | $5.2M |
| Stop-loss / reinsurancereinsurance | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 5,484 | $3.5M |
| Other(5 contracts, 5 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 5,358 | $2.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,484 | — |
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.