| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ARIZONA INC. | 16220 N SCOTTSDALE ROAD SUITE 600 SCOTTSDALE, AZ 85254 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | — | $43K | $43K | 1.03% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON US | PO BOX 28852 NEW YORK, NY 10087 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | — | $27K | $27K | 0.64% |
| WILLIS TOWERS WATSON US LLC3 | PO BOX 28852 NEW YORK, NY 10087 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $56K | $0 | $56K | 1.58% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ARIZONA INC. | 16220 N SCOTTSDALE ROAD SUITE 600 SCOTTSDALE, AZ 85254 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | — | $19K | $19K | 0.96% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON US | PO BOX 28852 NEW YORK, NY 10087 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | — | $13K | $13K | 0.64% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC | LOCKBOX #28025 28025 NETWORK PLACE CHICAGO, IL 606731280 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $11K | $0 | $11K | 13.11% |
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 | 10,577 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 327 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 10,904 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 2,433 | $12.7M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 2 | $85K |
| Life insurance | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 10,511 | $4.2M |
| Short-term disability | NATIONAL UNION FIRE INSURANCE CO. OF PITTSBURGH, PA | 10,577 | $23K |
| Long-term disability | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 10,598 | $2.0M |
| Prescription drug(3 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 2,433 | $12.6M |
| Stop-loss / reinsurancereinsurance | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 9,625 | $3.5M |
| Other(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 10,577 | $109K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 10,598 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.