| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 | 335 MADISON AVE FI 20 NEW YORK, NY 100174633 | RELIASTAR LIFE INSURANCE COMPANY | — | $278K | $278K | 6.00% |
| WILLIS TOWERS WATSON US LLC3 | LOCKBOX #28852 PO BOX 28852 NEW YORK, NY 100878852 | HARTFORD LIFE AND ACCIDENT | $137K | $55K | $193K | 4.98% |
| WILLIS TOWERS WATSON US LLC | LOCKBOX #28852 PO BOX 28852 NEW YORK, NY 100878852 | KAISER FOUNDATION HEALTH PLAN, INC. | $100K | — | $100K | 3.65% |
| WILLIS TOWERS WATSON US LLC | LOCKBOX #28852 PO BOX 28852 NEW YORK, NY 100878852 | KAISER FOUNDATION HEALTH PLAN, INC. | $18K | — | $18K | 4.15% |
| WILLIS TOWERS WATSON US LLC3 | LOCKBOX #28852 PO BOX 28852 NEW YORK, NY 100878852 | BLUE CROSS OF CALIFORNIA (G0200) | $5K | $656 | $6K | 10.41% |
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 | 10,438 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 81 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 304 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 10,823 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | KAISER FOUNDATION HEALTH PLAN, INC. | 276 | $3.2M |
| Dental(2 contracts, 2 carriers) | AETNA LIFE INSURANCE CO. | 1,998 | $380K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 13,845 | $3.9M |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 251 | $125K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 13,845 | $3.9M |
| Prescription drug(2 contracts) | KAISER FOUNDATION HEALTH PLAN, INC. | 276 | $3.2M |
| Other(3 contracts, 3 carriers) | RELIASTAR LIFE INSURANCE COMPANY | 13,845 | $8.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 13,845 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.