| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | 10940 WHITE ROCK ROAD 2ND FLOOR RANCHO CORDOVA, CA 95670 | BLUE SHIELD OF CALIFORNIA | $359K | $15K | $373K | 2.60% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | 21250 HAWTHORNE BLVD STE 600 TORRANCE, CA 90503 | METROPOLITAN LIFE INSURANCE COMPANY | $27K | $27 | $27K | 2.25% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | 1018 W 9TH AVE KING OF PRISSIA, PA 19406 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $21K | $21K | 1.76% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | 600 HIGHWAY 169 S 12TH FLOOR SAINT LOUIS PARK, MN 55426 | KAISER FOUNDATION HEALTH PLAN INC | $15K | — | $15K | 1.73% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | 21250 HAWTHORNE BLVD STE 600 TORRANCE, CA 90503 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $13K | $5K | $18K | 3.33% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | 21250 HAWTHORNE BLVD STE 600 TORRANCE, CA 90503 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $8K | $3K | $11K | 3.30% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | 21250 HAWTHORNE BLVD STE 600 TORRANCE, CA 90503 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $7K | $3K | $10K | 3.49% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | 21250 HAWTHORNE BLVD STE 600 TORRANCE, CA 90503 | VISION SERVICE PLAN | $4K | — | $4K | 2.05% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | 21250 HAWTHORNE BLVD STE 600 TORRANCE, CA 90503 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $890 | $3K | 3.45% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | DEPT 133667 SAN FRANCISCO, CA 94139 | AETNA LIFE INSURANCE COMPANY | $2K | — | $2K | 2.52% |
| WELLS FARGO INSURANCE SERVICES Filed as: WELLS FARGO INSURANCE SERVICES USA | 21250 HAWTHORNE BLVD STE 600 TORRANCE, CA 90503 | HARTFORD LIFE AND ACCIDENT | $511 | $153 | $664 | 19.50% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | 21250 HAWTHORNE BLVD STE 600 TORRANCE, CA 90503 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $43 | $43 | 2.11% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | 21250 HAWTHORNE BLVD STE 600 TORRANCE, CA 90503 | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | $0 | $22 | $22 | 2.67% |
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 | 1,828 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 15 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,843 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | BLUE SHIELD OF CALIFORNIA | 1,468 | $15.3M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 3,273 | $1.3M |
| Vision(2 contracts, 2 carriers) | VISION SERVICE PLAN | 1,572 | $273K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,826 | $528K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,014 | $291K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,828 | $327K |
| Prescription drug | BLUE SHIELD OF CALIFORNIA | 1,468 | $14.4M |
| Other(4 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,828 | $100K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,273 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.