| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS OF CA INC. | 18101 VON KARMAN AVENUE, SUITE 600 IRVINE, CA 92612 | UNITED HEALTHCARE INSURANCE COMPANY | $12K | — | $12K | 1.52% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS OF CA INC. | 18101 VON KARMAN AVENUE, SUITE 600 IRVINE, CA 92612 | PRINCIPAL LIFE INSURANCE COMPANY | $5K | $55 | $5K | 5.54% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS OF CA INC. | 18101 VON KARMAN AVENUE,SUITE 600 IRVINE, CA 92612 | METROPOLITAN LIFE INSURANCE COMPANY | $109 | $68 | $177 | 26.26% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $32 | $13 | $45 | 6.68% |
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 | 133 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 134 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITED HEALTHCARE INSURANCE COMPANY | 157 | $794K |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 133 | $93K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 133 | $93K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 133 | $93K |
| Prescription drug | UNITED HEALTHCARE INSURANCE COMPANY | 157 | $794K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 11 | $674 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 157 | — |
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."
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.