| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | PO BOX 101162 PASADENA, CA 91189 | BLUE CROSS OF CALIFORNIA | $342K | — | $342K | 5.44% |
| 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 | $58K | — | $58K | 9.51% |
| 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. | $20K | — | $20K | 6.02% |
| 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 | $30K | $4K | $34K | 14.27% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | PO BOX 101162 PASADENA, CA 91189 | VISION SERVICE PLAN | $14K | — | $14K | 9.99% |
| 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. | $2K | — | $2K | 5.22% |
| ABD INS. AND FINANCIAL SVCS., INC.3 Filed as: NEWFRONT INSURANCE SERVICES | 550 CALIFORNIA ST STE 302 SAN FRANCISCO, CA 94104 | FEDERAL INSURANCE COMPANY | $330 | $33 | $363 | 16.50% |
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 | 400 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 12 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 22 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 434 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 837 | $6.7M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF CALIFORNIA | 886 | $682K |
| Vision(2 contracts, 2 carriers) | VISION SERVICE PLAN | 385 | $211K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 405 | $239K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 405 | $239K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 405 | $239K |
| Prescription drug(4 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 837 | $6.7M |
| Other(3 contracts, 3 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 457 | $323K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 886 | — |
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.