| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CALIFORNIA, INC. | PO BOX 101162 PASADENA, CA 911890001 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 1.13% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 606036115 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $369 | $369 | 0.08% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF OHIO, INC. | 93245 NETWORK PLACE CHICAGO, IL 60673 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $50 | $2K | 5.29% |
| SMITH, THOMAS, CHRISTOPHER3 Filed as: SMITH, THOMAS. CHRISTOPHER | PO BOX 6650 METAIRIE, LA 70009 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $49 | $2K | 4.85% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF OHIO, INC. | 775 YARD ST SUITE 200 COLUMBUS, OH 432123891 | AETNA INTERNATIONAL | $1K | — | $1K | 13.39% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK, INC. | 200 LIBERTY STREET NEW YORK, NY 10281 | FEDERAL INSURANCE COMPANY | $2K | — | $2K | 25.00% |
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 | 925 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 19 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 950 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 55 | $66K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 1,292 | $320K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 943 | $473K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 943 | $473K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 943 | $473K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 13 | $57K |
| Other(3 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 943 | $517K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,292 | — |
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."
No prospect flags tripped on this filing.