| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE, INC | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 100878852 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | — | $11K | $11K | 1.40% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE, INC | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 100878852 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | — | $5K | $5K | 1.30% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC. | PO BOX 28852 NEW YORK, NY 100878852 | METROPOLITAN LIFE INSURANCE COMPANY | $21K | $2K | $23K | 18.14% |
| LIAZON BENEFITS INC3 | 199 SCOTT ST FL 8 BUFFALO, NY 142042265 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $7K | $7K | 5.46% |
| WELLS FARGO INSURANCE SERVICES3 | 1350 TREAT BLVD SUITE 550 WALNUT CREEK, CA 94597 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $12K | — | $12K | 11.53% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC | PO BOX 28852 NEW YORK, NY 100878852 | METROPOLITAN LIFE INSURANCE COMPANY | $14K | $1K | $15K | 17.65% |
| LIAZON BENEFITS INC3 | 199 SCOTT ST FL 8 BUFFALO, NY 142042265 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $5K | $5K | 5.30% |
| WELLS FARGO INSURANCE SERVICES3 | 1350 TREAT BLVD SUITE 550 WALNUT CREEK, CA 94597 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | — | $6K | 11.64% |
| USI INSURANCE SERVICES LLC3 | 1350 TREAT BOULEVARD SUITE 550 WALNUT CREEK, CA 94597 | FEDERAL INSURANCE COMPANY | $6K | — | $6K | 15.00% |
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 | 1,097 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 16 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 43 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,156 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 721 | $4.7M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 8 | $102K |
| Life insurance(2 contracts, 2 carriers) | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 1,068 | $802K |
| Long-term disability(2 contracts, 2 carriers) | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 1,067 | $459K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 721 | $4.5M |
| Stop-loss / reinsurancereinsurance | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 1,491 | $707K |
| Other(6 contracts, 5 carriers) | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 1,097 | $962K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,491 | — |
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."
No prospect flags tripped on this filing.