| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA, INC | 2055 GATEWAY PL STE 450 SAN JOSE, CA 95110 | KAISER FOUNDATION HEALTH PLAN INC | $215K | — | $215K | 4.94% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SERVICES | 525 MARKET STREET, STE 3400 SAN FRANCISCO, CA 941052775 | SYMETRA LIFE INSURANCE COMPANY | — | $196K | $196K | 4.95% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ARTHUR J GALLAGHER & CO | 2850 GOLF RD 5TH FLR ROLLING MEADOWS, IL 60008 | SYMETRA LIFE INSURANCE COMPANY | — | $7K | $7K | 0.18% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA INC | PO BOX 101162 PASADENA, CA 91189 | STANDARD INSURANCE COMPANY | $23K | $6K | $30K | 2.14% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA INC | PO BOX 101162 PASADENA, CA 91189 | STANDARD INSURANCE COMPANY | $14K | $3K | $17K | 3.02% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA | PO BOX 101162 PASADENA, CA 91189 | THE KONTERRA GROUP | $10K | — | $10K | 9.76% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC | 200 LIBERTY STREET 7TH FLOOR NEW YORK, NY 10281 | NATIONAL UNION FIRE INS. CO. OF PITTSBURGH, PA | $2K | — | $2K | 25.01% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA, INC. | 525 MARKET STREET SUITE 3400 SAN FRANCISCO, CA 94105 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | -$300 | $17K | $17K | — |
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 | 2,572 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 67 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 288 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,927 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 6,828 | $4.4M |
| Life insurance | STANDARD INSURANCE COMPANY | 2,722 | $1.4M |
| Long-term disability | STANDARD INSURANCE COMPANY | 2,722 | $547K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 736 | $4.4M |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | SYMETRA LIFE INSURANCE COMPANY | 6,828 | $4.0M |
| Other(3 contracts, 3 carriers) | STANDARD INSURANCE COMPANY | 3,873 | $1.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 6,828 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.