| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | 300 S GRAND AVE STE 2000 LOS ANGELES, CA 90071 | BLUE CROSS OF CALIFORNIA | $212K | — | $212K | 2.94% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | PO BOX 101162 PASADENA, CA 91189 | BLUE CROSS OF CALIFORNIA | $148K | — | $148K | 2.05% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | 4250 EXECUTIVE SQUARE SUITE 900 LA JOLLA, CA 92037 | DELTA DENTAL OF CALIFORNIA | $67K | — | $67K | 10.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA INC | 525 MARKET ST STE 3400 SAN FRANCISCO, CA 94105 | KAISER FOUNDATION HEALTH PLAN, INC. | $22K | — | $22K | 5.03% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE | 4250 EXECUTIVE SQUARE SUITE 900 LA JOLLA, CA 92037 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $27K | $2K | $29K | 13.06% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA INC | 525 MARKET ST STE 3400 SAN FRANCISCO, CA 94105 | KAISER FOUNDATION HEALTH PLAN, INC. | $5K | — | $5K | 5.21% |
| ABD INS. AND FINANCIAL SVCS., INC.3 Filed as: NEWFRONT INSURANCE SERVICES | 550 CALIFORNIA ST STE 302 SAN FRANCISCO, CA 94104 | FEDERAL INSURANCE COMPANY | $376 | $45 | $421 | 16.79% |
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 | 397 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 17 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 28 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 442 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 838 | $7.9M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF CALIFORNIA | 911 | $770K |
| Vision | HAWAII MEDICAL SERVICE ASSOCIATION | 10 | $97K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 371 | $220K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 371 | $220K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 371 | $220K |
| Prescription drug(4 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 838 | $7.9M |
| Other(3 contracts, 3 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 569 | $332K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 911 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.