| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY LLC | 9171 TOWNE CENTRE DR STE 500 SAN DIEGO, CA 92122 | CALIFORNIA PHYSICIANS SERVICE | -$2K | $31K | $30K | 2.62% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF OHIO INS BROKERS | 200 PUBLIC SQUARE 3760 CLEVELAND, OH 44114 | CALIFORNIA PHYSICIANS SERVICE | — | $29K | $29K | 2.57% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD AND BROWN | 701 S PARKER ST 8TH FL ORANGE, CA 92868 | CALIFORNIA PHYSICIANS SERVICE | — | -$22K | -$22K | -1.95% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY LLC | 6160 GOLDEN HILLS DR MINNEAPOLIS, MN 55416 | HEALTHPARTNERS INC | — | $17K | $17K | 4.71% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST INC | 93245 NETWORK PL CHICAGO, IL 60673 | HEALTHPARTNERS INC | — | $14K | $14K | 3.90% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY LLC | 7225 NORTHLAND DR N STE 300 MINNEAPOLIS, MN 55428 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $16K | — | $16K | 5.45% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDW | 8400 NORMANDALE LAKE BLVD STE 1700 BLOOMINGTON, MN 55437 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | — | $6K | 1.99% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: RJF A MARSH AND MCLENNAN AGENCY LLC | 7225 NORTHLAND DR N STE 300 MINNEAPOLIS, MN 55428 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $20 | — | $20 | 6.10% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF MINNESOTA INC | 93076 NETWORK PL CHICAGO, IL 60673 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $12 | — | $12 | 3.66% |
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 | 1,088 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 10 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,098 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA PHYSICIANS SERVICE | 155 | $1.1M |
| Dental | HEALTHPARTNERS INC | 835 | $354K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 6 | $328 |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,098 | $287K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,098 | $287K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,098 | $287K |
| Prescription drug | CALIFORNIA PHYSICIANS SERVICE | 155 | $1.1M |
| Other(2 contracts, 2 carriers) | HEALTHPARTNERS INC | 1,098 | $640K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,098 | — |
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.