| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SRVS WEST | PO BOX 101162 PASADENA, CA 91189 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $229K | — | $229K | 2.95% |
| MCGRIFF INSURANCE SERVICES INC3 | 7701 AIRPORT CENTER DR #1800 GREENSBORO, NC 27409 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | -$500 | — | -$500 | -0.01% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | 345 CALIFORNIA ST SUITE 2000 SAN FRANCISCO, CA 94104 | DELTA DENTAL OF CALIFORNIA | $23K | — | $23K | 4.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS | 345 CALIFORNIA STREET SUITE 2000 SAN FRANCISCO, CA 94104 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $20K | — | $20K | 8.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS OF CA INC | 525 MARKET STREET STE 3400 SAN FRANCISCO, CA 94105 | KAISER FOUNDATION HEALTH PLAN INC | $5K | — | $5K | 2.70% |
| MCGRIFF INSURANCE SERVICES INC3 | 750 B ST STE 2400 SAN DIEGO, CA 92101 | KAISER FOUNDATION HEALTH PLAN INC | -$23 | — | -$23 | -0.01% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS | 345 CALIFORNIA STREET SUITE 2000 SAN FRANCISCO, CA 94104 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $13K | — | $13K | 8.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS | 345 CALIFORNIA STREET SUITE 2000 SAN FRANCISCO, CA 94104 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $15K | — | $15K | 15.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS | 345 CALIFORNIA STREET SUITE 2000 SAN FRANCISCO, CA 94104 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $12K | — | $12K | 15.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | 525 MARKET STREET STE 3400 SAN FRANCISCO, CA 94105 | AMERITAS LIFE INSURANCE CORP. | $6K | — | $6K | 8.00% |
| WILLIS TOWERS WATSON US LLC4 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | 18101 VON KARMAN AVE STE 600 IRVINE, CA 92612 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $6K | — | $6K | 17.00% |
| KAI DEERING4 | 699 BORREGAS AVE SUNNYVALE, CA 94085 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $679 | — | $679 | 2.02% |
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 | 2,892 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 27 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 212 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 3,131 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 6,047 | $8.0M |
| Dental | DELTA DENTAL OF CALIFORNIA | 6,516 | $579K |
| Vision | AMERITAS LIFE INSURANCE CORP. | 5,781 | $78K |
| Life insurance(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 2,840 | $182K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 2,670 | $252K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 2,670 | $160K |
| Prescription drug(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 6,047 | $8.0M |
| Other(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 2,840 | $115K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 6,516 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.