| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA, INC. | PO BOX 101162 PASADENA, CA 91189 | KAISER FOUNDATION HEALTH PLAN INC | $23K | — | $23K | 1.34% |
| INSURANCE OFFICE OF AMERICA3 Filed as: INSURANCE OFFICE OF AMERICA INC | 1855 W STATE ROAD 434 LONGWOOD, FL 327505069 | KAISER FOUNDATION HEALTH PLAN INC | $10K | — | $10K | 0.59% |
| VOLUNTARY BENEFIT ADVISORS3 | 2400 MAIN STREET SUITE 200 IRVINE, CA 92614 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $93K | $10K | $103K | 28.21% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | PO BOX 101162 PASADENA, CA 91189 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $40K | $3K | $43K | 11.81% |
| DIRECTPATH, LLC3 | 120 18TH STREET SOUTH SUITE 102 BIRMINGHAM, AL 35233 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $183 | — | $183 | 0.05% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST INC. | 233 S. WACKER DRIVE SUITE 2000 CHICAGO, IL 60606 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $14 | — | $14 | 0.00% |
| VOLUNTARY BENEFIT ADVISORS3 | 2400 MAIN STREET #200 IRVINE, CA 92614 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $91K | $9K | $100K | 30.99% |
| 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 | $40K | $3K | $43K | 13.16% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST INC. | 233 S. WACKER DRIVE SUITE 2000 CHICAGO, IL 60606 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 0.40% |
| DIRECTPATH, LLC3 | 120 18TH STREET S SUITE 102 BIRMINGHAM, AL 35233 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $278 | — | $278 | 0.09% |
| INSURANCE OFFICE OF AMERICA3 Filed as: INSURANCE OFFICE OF AMERICA, INC. | 1855 W. STATE ROAD 434 LONGWOOD, FL 32750 | UNITED CONCORDIA INSURANCE COMPANY | -$40 | — | -$40 | -0.01% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE SVCS | 525 MARKET STREET SUITE 3400 SAN FRANCISCO, CA 94105 | SIMNSA | $6K | — | $6K | 2.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE | 18101 VON KARMAN AVE SUITE 600 IRVINE, CA 92612 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | $861 | $8K | 11.25% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON WEST INC | PO BOX 101162 PASADENA, CA 91189 | STANDARD INSURANCE COMPANY | $1K | — | $1K | 4.99% |
| INSURANCE OFFICE OF AMERICA3 Filed as: INSURANCE OFFICE AMERICA INC | 130 VANTIS SUITE 250 ALISO VIEJO, CA 92656 | STANDARD INSURANCE COMPANY | $2 | — | $2 | 0.01% |
| INSURANCE OFFICE OF AMERICA3 Filed as: INSURANCE OFFICE OF AMERICA INC | 1855 W STATE ROAD 434 LONGWOOD, FL 32750 | UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. | $1 | — | $1 | 0.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE | 18101 VON KARMAN AVE SUITE 600 IRVINE, CA 92612 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $175 | $2K | 11.25% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE | 18101 VON KARMAN AVE SUITE 600 IRVINE, CA 92612 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $68 | $1K | 10.63% |
| VOLUNTARY BENEFIT ADVISORS3 | 2400 MAIN ST SUITE 200 IRVINE, CA 92614 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $41 | $1K | 10.38% |
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 | 3,811 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 17 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 78 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 3,906 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 1,231 | $2.0M |
| Dental(2 contracts, 2 carriers) | UNITED CONCORDIA INSURANCE COMPANY | 3,029 | $335K |
| Vision | STANDARD INSURANCE COMPANY | 1,928 | $28K |
| Life insurance(2 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 3,833 | $392K |
| Short-term disability(2 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 3,689 | $337K |
| Long-term disability(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 380 | $25K |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 5,512 | $433K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,512 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.