| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS. SVCS WEST | PO BOX 101162 PASADENA, CA 91189 | BLUE CROSS OF CALIFORNIA | $240K | — | $240K | 1.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS. SVCS WEST | 300 S. GRAND AVE. SUITE 2000 LOS ANGELES, CA 90071 | BLUE CROSS OF CALIFORNIA | $22K | — | $22K | 0.09% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS. SVCS WEST | PO BOX 101162 PASADENA, CA 91189 | DELTA DENTAL OF CALIFORNIA | $147K | — | $147K | 8.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS. SVCS WEST | PO BOX 101162 PASADENA, CA 91189 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $86K | — | $86K | 10.33% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC | PO BOX 416672 BOSTON, MA 02241 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $148 | $148 | 0.02% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS. SVCS WEST | PO BOX 101162 PASADENA, CA 91189 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $60K | — | $60K | 10.83% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC | PO BOX 416672 BOSTON, MA 02241 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $74 | $74 | 0.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | DBA CBA 2000 MORRIS AVE STE 1400 BIRMINGHAM, AL 35203 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $55K | — | $55K | 10.68% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | PO BOX 101162 PASADENA, CA 91189 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $16K | $854 | $16K | 3.19% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 W GOLF RD ROLLING MEADOWS, IL 60008 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $8K | $8K | 1.51% |
| GRIFFIN, STEVEN, RAY3 | 2000 MORRIS AVE STE 1400 BIRMINGHAM, AL 35203 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $7K | — | $7K | 1.39% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS | AON COMPANY 1 N WHITE HORSE PIKE #2 HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 0.21% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY | 10320 ORLAND PKWY ORLAND PARK, IL 60467 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $293 | — | $293 | 0.06% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SVCS INC | 3635 RIVERSIDE PLAZA DRIVE BUILDING M3, SUITE 320 RIVERSIDE, CA 92506 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $38 | — | $38 | 0.01% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS. SVCS WEST | PO BOX 101162 PASADENA, CA 91189 | VISION SERVICE PLAN | $13K | — | $13K | 2.76% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2000 MORRIS AVE APT 1400 BIRMINGHAM, AL 35203 | METROPOLITAN LIFE INSURANCE COMPANY | $45K | $107 | $45K | 9.47% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS. SVCS WEST | PO BOX 101162 PASADENA, CA 91189 | METROPOLITAN LIFE INSURANCE COMPANY | $15K | $2K | $17K | 3.64% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 95287 CHICAGO, IL 60690 | METROPOLITAN LIFE INSURANCE COMPANY | — | $6K | $6K | 1.20% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS. SVCS WEST | PO BOX 101162 PASADENA, CA 91189 | DELTA DENTAL OF CALIFORNIA | $18K | — | $18K | 8.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2000 MORRIS AVE APT 1400 BIRMINGHAM, AL 35203 | METROPOLITAN LIFE INSURANCE COMPANY | $38K | $107 | $38K | 20.74% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS. SVCS WEST | PO BOX 101162 PASADENA, CA 91189 | METROPOLITAN LIFE INSURANCE COMPANY | $13K | $943 | $14K | 7.41% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 95287 CHICAGO, IL 60694 | METROPOLITAN LIFE INSURANCE COMPANY | — | $2K | $2K | 1.20% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS. SVCS WEST | PO BOX 101162 PASADENA, CA 91189 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $19K | — | $19K | 10.83% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC | PO BOX 416672 BOSTON, MA 02241 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $74 | $74 | 0.04% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS. SVCS WEST | PO BOX 101162 PASADENA, CA 91189 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $16K | — | $16K | 10.45% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC | PO BOX 416672 BOSTON, MA 02241 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $148 | $148 | 0.10% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SERVICES OF CA INC | PO BOX 101162 PASADENA, CA 91189 | METLIFE LEGAL PLANS | $10K | — | $10K | 10.85% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS. SVCS WEST | 62877 COLLECTIONS DR CHICAGO, IL 60693 | METLIFE LEGAL PLANS | — | $2K | $2K | 2.20% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS | 801 S. FIGUEROA STREET SUITE 700 LOS ANGELES, CA 90017 | METLIFE LEGAL PLANS | — | $105 | $105 | 0.11% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS. SVCS WEST | 4250 EXECUTIVE SQUARE SUITE 250 LA JOLLA, CA 92037 | METLIFE LEGAL PLANS | — | $63 | $63 | 0.07% |
| GRIFFIN, STEVEN, RAY3 | STE 1400 2000 MORRIS AVE BIRMINGHAM, AL 35203 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $428 | — | $428 | 3.19% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | P.O. BOX 101162 PASADENA, CA 91189 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $184 | — | $184 | 1.37% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS, INC. | AN AON COMPANY 1 N WHITE HORSE PIKE #2 HAMMONTON, NJ 08037 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $170 | — | $170 | 1.27% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | DBA CBA 2000 MORRIS AVE STE 1400 BIRMINGHAM, AL 35203 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $60 | — | $60 | 0.45% |
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 | 2,575 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 11 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 110 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,696 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 5,098 | $24.1M |
| Dental(2 contracts) | DELTA DENTAL OF CALIFORNIA | 3,475 | $2.1M |
| Vision | VISION SERVICE PLAN | 2,406 | $477K |
| Life insurance(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 4,523 | $1.3M |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 450 | $559K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 374 | $173K |
| Other(5 contracts, 5 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 4,059 | $815K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,098 | — |
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.