| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA, INC. | 18101 VON KARMAN AVENUE, SUITE 600 IRVINE, CA 92612 | CALIFORNIA PHYSICIANS' SERVICE | $43 | $207K | $207K | 2.64% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA INC | PO BOX 101162 PASADENA, CA 91189 | KAISER FOUNDATION HEALTH PLAN INC. | $62K | — | $62K | 3.48% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | PO BOX 101162 PASADENA, CA 91189 | METROPOLITAN LIFE INSURANCE COMPANY | $40K | $11K | $51K | 6.30% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA INC. | PO BOX 100003 PASADENA, CA 91189 | RELIASTAR LIFE INSURANCE COMPANY | $24K | — | $24K | 5.37% |
| PLANSOURCE BENEFITS ADMINISTRATION3 Filed as: PLANSOURCE BENEFITS ADMIN INC. | 101 S GARLAND AVE STE 203 ORLANDO, FL 32801 | RELIASTAR LIFE INSURANCE COMPANY | — | $737 | $737 | 0.16% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA INC | PO BOX 101162 PASADENA, CA 91189 | VISION SERVICE PLAN | $6K | — | $6K | 4.54% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 1166 AVENUE OF THE AMERICAS 22ND FLOOR NEW YORK, NY 10036 | NATIONAL UNION FIRE INS. CO. OF PITTSBURGH, PA | $4K | — | $4K | 15.00% |
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 | 562 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 12 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 24 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 598 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 382 | $9.6M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 1,265 | $814K |
| Vision | VISION SERVICE PLAN | 564 | $130K |
| Life insurance | RELIASTAR LIFE INSURANCE COMPANY | 552 | $447K |
| Short-term disability | RELIASTAR LIFE INSURANCE COMPANY | 552 | $447K |
| Long-term disability | RELIASTAR LIFE INSURANCE COMPANY | 552 | $447K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 382 | $9.6M |
| Other(3 contracts, 2 carriers) | RELIASTAR LIFE INSURANCE COMPANY | 562 | $476K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,265 | — |
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.