| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS OF CA INC. | 18101 VON KARMAN AVENUE, SUITE 600 IRVINE, CA 92612 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $23K | $711 | $24K | 4.17% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE | SERVICES WEST, INC. 801 S FIGUEROA STREET, SUITE 800 LOS ANGELES, CA 900172591 | KAISER FOUNDATION HEALTH PLAN INC | $17K | — | $17K | 4.97% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS OF CA INC. | 18101 VON KARMAN AVENUE, SUITE 600 IRVINE, CA 92612 | BLUE CROSS OF CALIFORNIA | $12K | $379 | $13K | 4.17% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE | SERVICES WEST, INC. 801 S. FIGUEROA STREET, SUITE 800 LOS ANGELES, CA 900172591 | KAISER FOUNDATION HEALTH PLAN INC. | $6K | — | $6K | 4.77% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE | SERVICES WEST, INC. PO BOX 101162 PASADENA, CA 911890005 | METROPOLITAN LIFE INSURANCE COMPANY | $11K | $2K | $12K | 10.01% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE | SERVICES WEST, INC. 801 SOUTH FIGUEROA ST, SUITE 800 LOS ANGELES, CA 90017 | KAISER FOUNDATION HEALTH PLAN OF COLORADO | $1K | — | $1K | 3.55% |
| VOLUNTARY BENEFIT ADVISORS3 | 2400 MAIN STREET SUITE 200 IRVINE, CA 926146271 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | — | $1K | 7.50% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE | SERVICES WEST, INC. PO BOX 101162 PASADENA, CA 911890005 | METROPOLITAN LIFE INSURANCE COMPANY | $509 | $123 | $632 | 3.99% |
| VOLUNTARY BENEFIT ADVISORS3 | 2400 MAIN STREET SUITE 200 IRVINE, CA 926146271 | METROPOLITAN LIFE INSURANCE COMPANY | $992 | — | $992 | 7.59% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE | SERVICES WEST INC PO BOX 101162 PASADENA, CA 911890005 | METROPOLITAN LIFE INSURANCE COMPANY | $425 | $84 | $509 | 3.90% |
| VOLUNTARY BENEFIT ADVISORS3 | 2400 MAIN STREET SUITE 200 IRVINE, CA 926146271 | METROPOLITAN LIFE INSURANCE COMPANY | $688 | — | $688 | 7.14% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WASTON INSURANCE | SERVICES WEST INC PO BOX 101162 PASADENA, CA 911890005 | METROPOLITAN LIFE INSURANCE COMPANY | $294 | $84 | $378 | 3.92% |
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 | 0 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(7 contracts, 5 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 240 | $1.4M |
| Dental | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 240 | $575K |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 240 | $575K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 157 | $122K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 157 | $122K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 157 | $122K |
| Prescription drug(5 contracts, 4 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 240 | $1.4M |
| Other(2 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 157 | $138K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 240 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.