| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 | LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $28K | $28K | 1.41% |
| WILLIS TOWERS WATSON US LLC3 | LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $23K | $23K | 1.42% |
| BENEFITSTORE INC3 Filed as: BENEFITSTORE, INC | 100 BENEFITFOCUS WAY CHARLESTON, SC 294928378 | TRANSAMERICA LIFE INSURANCE COMPANY | $321K | — | $321K | 24.13% |
| WILLIS TOWERS WATSON US LLC3 | LOCKBOX 28852 PO BOX 28852 NEW YORK, NC 10087 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $18K | $18K | 1.49% |
| WILLIS TOWERS WATSON US LLC3 | LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | VISION SERVICE PLAN | $109K | — | $109K | 10.76% |
| WILLIS TOWERS WATSON US LLC3 | LOCKBOX #28852 PO BOX #28852 NEW YORK, NY 10087 | METLIFE LEGAL PLANS | $16K | $3K | $19K | 11.14% |
| BENEFITFOCUS.COM, INC.3 | DEPT. 3383 PO BOX 123383 DALLAS, TX 75312 | METLIFE LEGAL PLANS | $0 | $2K | $2K | 1.05% |
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 444 W 47TH STREET SUITE 900 KANSAS CITY, MO 64112 | NATIONAL UNION FIRE INSURANCE CO. OF PITTSBURGH, PA | $4K | — | $4K | 25.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| US BANK NONE | Direct payment from the plan; Trustee (bank, trust company, or similar financial institution) Service code 21 | 633 W. 5TH STREET, 24TH FLOOR LOS ANGELES, CA 90071 | $9K |
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 | 22,530 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 135 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 22,665 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(9 contracts, 9 carriers) | KAISER FOUNDATION HEALTH PLAN INC.- CA SOUTH | 1,033 | $10.0M |
| Dental | DELTA DENTAL OF CALIFORNIA | 2,512 | $499K |
| Vision | VISION SERVICE PLAN | 8,308 | $1.0M |
| Life insurance | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 20,757 | $1.6M |
| Short-term disability | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 5,470 | $1.2M |
| Long-term disability | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 6,839 | $2.0M |
| Prescription drug(9 contracts, 9 carriers) | KAISER FOUNDATION HEALTH PLAN INC.- CA SOUTH | 1,033 | $10.0M |
| Other(4 contracts, 4 carriers) | TRANSAMERICA LIFE INSURANCE COMPANY | 31,447 | $1.8M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 31,447 | — |
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.