| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA, INC. | PO BOX 101162 PASADENA, CA 91189 | KAISER FOUNDATION HEALTH PLAN INC | $15K | — | $15K | 3.99% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA, INC. | 525 MARKET STREET SUITE 3400 SAN FRANCISCO, CA 94105 | PREMIER ACCESS INSURANCE COMPANY | $2K | — | $2K | 9.16% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | PO BOX 101162 PASADENA, CA 91189 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | — | $1K | 15.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC | 233 S WACKER DR STE 2000 CHICAGO, IL 60606 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $450 | $450 | 6.31% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA, INC. | 525 MARKET STREET SUITE 3400 SAN FRANCISCO, CA 94105 | PREMIER ACCESS INSURANCE COMPANY | $545 | — | $545 | 9.41% |
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 | 135 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 135 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 80 | $374K |
| Dental | PREMIER ACCESS INSURANCE COMPANY | 83 | $24K |
| Vision | PREMIER ACCESS INSURANCE COMPANY | 60 | $6K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 135 | $7K |
| Other | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 135 | $7K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 135 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.