| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON US | LOCKBOX 28025 CHICAGO, IL 60673 | DELTA DENTAL | $100K | — | $100K | 6.00% |
| MORGAN & FRANZ INSURANCE AND FINANC3 Filed as: MORGAN & FRANZ INSURANCE & FINANCE | 10606 TRADEMARK PKWY N. #201A RANCHO CUCAMONGA, CA 91730 | KAISER PERMANENTE | $18K | — | $18K | 3.80% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON | 93245 NETWORK PLACE CHICAGO, IL 60673 | EYEMED VISION CARE | $16K | — | $16K | 4.57% |
| COMMUNITY INSURANCE COMPANY3 | — | ANTHEM | — | $2.8M | $2.8M | 823.79% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST | 775 YARD ST SUITE 200 COLUMBUS, OH 43212 | ANTHEM | $149K | — | $149K | 44.60% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON | 93245 NETWORK PLACE CHICAGO, IL 60673 | EYEMED VISION CARE | $609 | — | $609 | 3.24% |
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 | 3,960 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 68 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 4,028 | Active + retired/separated + beneficiaries. No dependents. |
No Schedule A insurance contracts on this filing — typical of fully self-funded plans, where the only headcount is the Form 5500 number above.
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.