| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 | 701 B ST. FL 6 SAN DIEGO, CA 92101 | KAISER FOUNDATION HEALTH PLAN, INC. | $36K | — | $36K | 3.87% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST, INC | 12505 PARK POTOMAC AVE STE 300 POTOMAC, MD 20854 | KAISER FOUNDATION HEALTH PLAN, INC. | $7K | — | $7K | 0.78% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC. | 18100 VON KARMAN AVE IRVINE, CA 92612 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $18K | — | $18K | 6.24% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST | 29754 NETWORK PL CHICAGO, IL 60673 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $9K | — | $9K | 3.02% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE SERV | PO BOX 101162 PASADENA, CA 91189 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $3K | $3K | 1.15% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC. | PO BOX 416672 BOSTON, MA 02241 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $148 | $148 | 0.05% |
| ALLIANT INSURANCE SERVICES, INC.3 | 701 B ST. FL 6 SAN DIEGO, CA 92101 | RELIASTAR LIFE INSURANCE COMPANY | $46K | — | $46K | 16.63% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST, INC | PO BOX 905643 CHARLOTTE, NC 28290 | RELIASTAR LIFE INSURANCE COMPANY | $13K | — | $13K | 4.57% |
| PLANSOURCE BENEFITS ADMINISTRATION3 Filed as: PLANSOURCE BENEFITS ADMINSITRATION | 101 S. GARLAND AVE STE 203 ORLAND, FL 32801 | RELIASTAR LIFE INSURANCE COMPANY | — | $4K | $4K | 1.37% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC. | 18100 VON KARMAN AVE IRVINE, CA 92612 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $9K | — | $9K | 4.01% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST, INC | 29754 NETWORK PL CHICAGO, IL 60673 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | — | $5K | 1.99% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE SERV | PO BOX 101162 PASADENA, CA 91189 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $3K | $3K | 1.21% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC. | PO BOX 416672 BOSTON, MA 02241 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $74 | $74 | 0.03% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES | PO BOX 745977 LOS ANGELES, CA 90074 | VISION SERVICE PLAN | $3K | — | $3K | 1.62% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST INC. | 29754 NETWORK PL CHICAGO, IL 60673 | VISION SERVICE PLAN | $2K | — | $2K | 0.90% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC. | 18100 VON KARMAN AVE IRVINE, CA 92612 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 5.20% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST, INC | 29754 NETWORK PLACE CHICAGO, IL 60673 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $690 | — | $690 | 2.51% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE SERV | PO BOX 101162 PASADENA, CA 91189 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $319 | $319 | 1.16% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST INC. | PO BOX 416672 BOSTON, MA 02241 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $148 | $148 | 0.54% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUECROSS BLUE SHIELD OF SOUTH CARO EIN 57-0287419 SERVICE PROVIDER | Contract Administrator; Claims processing Service code 12 | — | $848K |
| WILLIS TOWERS WATSON SOUTHEAST BROKER | Other commissions Service code 55 | P.O. BOX 31817 CHARLOTTE, NC 28231 | $848K |
| EXPRESS SCRIPTS SERVICE PROVIDER | Contract Administrator; Claims processing Service code 12 | 1 EXPRESS WAY ST. LOUIS, MO 63121 | $436K |
| DELTA DENTAL OF MISSOURI EIN 43-0908349 SERVICE PROVIDER | Claims processing; Contract Administrator Service code 12 | — | $48K |
| ALLIANT INSURANCE SERVICES BROKER | Other commissions Service code 55 | PO BOX 745977 LOS ANGELES, CA 90074 | $39K |
| FLORES AND ASSOCIATES EIN 56-1542307 FSA ADMIN | Contract Administrator; Claims processing Service code 12 | — | $2K |
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 | 1,396 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,402 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN, INC. | 127 | $922K |
| Vision | VISION SERVICE PLAN | 943 | $211K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $284K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $236K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $236K |
| Other(2 contracts, 2 carriers) | RELIASTAR LIFE INSURANCE COMPANY | 830 | $306K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 943 | — |
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.