| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS. SERVICES | 16220 NORTH SCOTTSDALE ROAD SUITE 600 SCOTTSDALE, AZ 85254 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $377K | $0 | $377K | 12.18% |
| USI INSURANCE SERVICES LLC3 Filed as: KIBBLE & PRENTICE HOLDING COMPANY | PO BOX 62949 VIRGINIA BEACH, VA 23466 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $20K | $20K | 0.65% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS. SERVICES | PO BOX 101162 PASADENA, CA 91189 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $8K | $8K | 0.27% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, MN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $1K | $1K | 0.04% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS. SERVICES | 801 SOUTH FIGUEROA STREET LOS ANGELES, CA 90017 | DELTA DENTAL OF WASHINGTON | $60K | $0 | $60K | 2.36% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS. SERVICES | 801 SOUTH FIGUEROA STREET SUITE 800 LOS ANGELES, CA 90017 | KAISER FOUNDATION HEALTH PLAN INC | $146 | $0 | $146 | 0.01% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS. SERVICES | PO BOX 730054 DALLAS, TX 75373 | VISION SERVICE PLAN | $6K | $0 | $6K | 1.51% |
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 | 6,388 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 63 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 6,451 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 337 | $1.8M |
| Dental | DELTA DENTAL OF WASHINGTON | 6,334 | $2.5M |
| Vision | VISION SERVICE PLAN | 3,628 | $378K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 6,388 | $3.1M |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 6,388 | $3.1M |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 6,388 | $3.1M |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 337 | $1.8M |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 6,388 | $3.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 6,388 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
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.