| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA INC | 2055 GATEWAY PLACE STE 450 SAN JOSE, CA 95110 | AETNA | $24K | — | $24K | 3.68% |
| ROGERS BENEFIT GROUP INC3 | 6000 GISHOLT DR MONONA, WI 53713 | AETNA | $12K | — | $12K | 1.87% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER INC | 800 MAIN STREET DUBUQUE, IA 52001 | AETNA | $9K | — | $9K | 1.32% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE | SERVICES WEST INC 2055 GATEWAY PLACE STE 450 SAN JOSE, CA 95110 | ANTHEM LIFE INSURANCE COMPANY | $928 | — | $928 | 15.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE | SERVICES WEST INC 2055 GATEWAY PLACE STE 450 SAN JOSE, CA 95110 | ANTHEM HEALTH PLANS, INC. | $382 | $120 | $502 | — |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM AND BUTLER INSURANCE | SERVICES LLC 800 MAIN STREET DUBUQUE, IA 52001 | ANTHEM HEALTH PLANS, INC. | $82 | — | $82 | — |
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 | 120 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 121 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA | 104 | $646K |
| Vision | ANTHEM HEALTH PLANS, INC. | 0 | $0 |
| Life insurance | ANTHEM LIFE INSURANCE COMPANY | 120 | $6K |
| Other | ANTHEM LIFE INSURANCE COMPANY | 120 | $6K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 120 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.