| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS | 18101 VON KARMAN AVE., 6TH FLOOR IRVINE, CA 92612 | KAISER FOUNDATION HEALTH PLAN INC. | $22K | $17 | $22K | 2.66% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS | 18101 VON KARMAN AVENUE, SUITE 600 IRVINE, CA 92612 | SELECT HEALTH | $7K | — | $7K | 2.98% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS | 18101 VON KARMAN AVE., 6TH FLOOR IRVINE, CA 92612 | PRINCIPAL LIFE INSURANCE COMPANY | $5K | — | $5K | 6.55% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS | 18101 VON KARMAN AVE., 6TH FLOOR IRVINE, CA 92612 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | $1K | $8K | 16.80% |
| TBX EMPLOYEE BENEFITS LLC3 Filed as: TBX EMPLOYEE BENEFITS, LLC | 1201 ELM STREET, SUITE 4250 DALLAS, TX 75270 | TRANSAMERICA LIFE INSURANCE COMPANY | $19K | — | $19K | 58.50% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS | 18101 VON KARMAN AVENUE, SUITE 600 IRVINE, CA 92612 | TRANSAMERICA LIFE INSURANCE COMPANY | $2K | — | $2K | 5.72% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS | 18101 VON KARMAN AVE., 6TH FLOOR IRVINE, CA 92612 | CALIFORNIA DENTAL NETWORK, INC. | $784 | — | $784 | 10.00% |
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 | 263 | 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) | 264 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 143 | $1.1M |
| Dental(3 contracts, 3 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 203 | $128K |
| Vision(2 contracts, 2 carriers) | SELECT HEALTH | 203 | $323K |
| Life insurance(3 contracts, 3 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 203 | $153K |
| Short-term disability | TRANSAMERICA LIFE INSURANCE COMPANY | 99 | $33K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 143 | $1.1M |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 101 | $78K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 203 | — |
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.