| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SVCS USA INC | 600 HIGHWAY 169 SOUTH SUITE 1200 ST LOUIS PARK, MN 55426 | AETNA HEALTH, INC | $25K | $12K | $37K | 1.81% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA INC | 100485 BANC ONE DEPT PASADENA, CA 91189 | AETNA HEALTH, INC | $17K | — | $17K | 0.83% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SVCS USA INC | 600 HIGHWAY 169 SOUTH SUITE 1200 ST LOUIS PARK, MN 55426 | AETNA LIFE INSURANCE CO. | $13K | $526 | $14K | 1.34% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA INC | 100485 BANC ONE DEPT PASADENA, CA 91189 | AETNA LIFE INSURANCE CO. | $10K | — | $10K | 0.91% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SVCS USA INC | 5901 PRIESTLY DRIVE SUITE 306 CARLSBAD, CA 92008 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $2K | — | $2K | 1.59% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS OF CA | 801 S. FIGUEROA ST 700 LOS ANGELES, CA 90017 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $933 | — | $933 | 0.92% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | 21250 HAWTHORNE BLVD STE 600 TORRANCE, CA 90503 | VISION SERVICE PLAN | $1K | — | $1K | 2.80% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SERVICES OF CA | PO BOX 101162 PASADENA, CA 91189 | VISION SERVICE PLAN | $525 | — | $525 | 1.37% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA INC | 4250 EXECUTIVE SQ STE 250 LA JOLLA, CA 92037 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 7.62% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SVCS USA INC | 1250 HAWTHORNE BLVD STE 600 TORRANCE, CA 90503 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 7.38% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SVCS USA INC | PO BOX 203066 DALLAS, TX 75320 | STANDARD INSURANCE COMPANY | -$272 | — | -$272 | -1.09% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS AGCY USA INC | PO BOX 39000 DEPT 133667 SAN FRANCISCO, CA 94139 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 8.26% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS RISK & INS SVCS OF CA INC | PO BOX 101162 PASADENA, CA 91189 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 6.74% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SVCS USA INC | 5901 PRIESTLY DRIVE SUITE 306 CARLSBAD, CA 92008 | HAWAII DENTAL SERVICE | $38 | — | $38 | 1.71% |
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 | 388 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 47 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 440 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | AETNA HEALTH, INC | 512 | $3.2M |
| Dental(3 contracts, 2 carriers) | DELTA DENTAL OF CALIFORNIA | 142 | $179K |
| Vision | VISION SERVICE PLAN | 243 | $38K |
| Life insurance(2 contracts, 2 carriers) | AETNA LIFE INSURANCE CO. | 409 | $1.1M |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 6 | $4K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 39 | $24K |
| Other | AETNA LIFE INSURANCE CO. | 409 | $1.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 512 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.