| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS. SERVICES OF CA, INC. | 525 MARKET STREET, SUITE 3400 SAN FRANCISCO, CA 94105 | KAISER FOUNDATION HEALTH PLAN, INC. | $113K | $0 | $113K | 2.01% |
| VOLUNTARY BENEFIT ADVISORS3 | 2400 MAIN STREET, SUITE 200 IRVINE, CA 92614 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $214K | $14K | $229K | 13.08% |
| 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 | $89K | $6K | $95K | 5.42% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE | 2010 MAIN STREET, SUITE 1050 IRVINE, CA 92614 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $38K | $4K | $43K | 2.45% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC. | 233 SOUTH WACKER DRIVE, SUITE 2000 CHICAGO, IL 60606 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $47 | $0 | $47 | 0.00% |
| VOLUNTARY BENEFIT ADVISORS3 | 2400 MAIN STREET, SUITE 200 IRVINE, CA 92614 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $219K | $14K | $233K | 18.73% |
| 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 | $95K | $6K | $101K | 8.13% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC. | 233 SOUTH WACKER DRIVE, SUITE 2000 CHICAGO, IL 60606 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 0.20% |
| DIRECTPATH, LLC3 | 120 18TH STREET SOUTH, SUITE 102 BIRMINGHAM, AL 35233 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $593 | $0 | $593 | 0.05% |
| LOCKTON COMPANIES, LLC3 | 777 SOUTH FIGUEROA STREET LOS ANGELES, CA 90017 | SIMNSA | $18K | $0 | $18K | 2.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE | 16220 NORTH SCOTTSDALE ROAD SUITE 600 SCOTTSDALE, AZ 85254 | STARMOUNT LIFE INSURANCE COMPANY | $5K | $1K | $6K | 6.46% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS. SERVICES OF CA, INC. | PO BOX 101162 PASADENA, CA 91189 | UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. | $6K | $793 | $7K | 7.37% |
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 | 3,658 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 10 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 3,668 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 878 | $6.5M |
| Dental | UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. | 688 | $97K |
| Vision | STARMOUNT LIFE INSURANCE COMPANY | 1,728 | $101K |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 5,347 | $3.0M |
| Short-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 5,347 | $3.0M |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 5,347 | $1.7M |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 878 | $6.5M |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 5,347 | $1.7M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,347 | — |
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.