| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE, INC. | P.O. BOX 8500 LOCKBOX 9102 PHILADELPHIA, PA 19178 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $163K | — | $163K | 9.52% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE, INC. | P.O. BOX 8500 LOCKBOX 9102 PHILADELPHIA, PA 19178 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $39K | — | $39K | 10.00% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE, INC. | P.O. BOX 8500 LOCKBOX 9102 PHILADELPHIA, PA 19178 | KAISER FOUNDATION HEALTH PLAN INC. | $7K | — | $7K | 2.00% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE, INC. | P.O. BOX 8500 LOCKBOX 9102 PHILADELPHIA, PA 19178 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $19K | — | $19K | 9.36% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE, INC. | P.O. BOX 8500 LOCKBOX 9102 PHILADELPHIA, PA 19178 | KAISER FOUNDATION HEALTH PLAN INC. | $2K | — | $2K | 1.33% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE, INC. | P.O. BOX 8500 LOCKBOX 9102 PHILADELPHIA, PA 19178 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $11K | — | $11K | 10.00% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE, INC. | P.O. BOX 8500 LOCKBOX 9102 PHILADELPHIA, PA 19178 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
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 | 1,368 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 16 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,384 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC. | 95 | $491K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 2,867 | $1.7M |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 2,867 | $1.7M |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,537 | $393K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,384 | $208K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC. | 95 | $351K |
| Other(3 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,537 | $522K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,867 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.