| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SRVS WEST | PO BOX 101162 PASADENA, CA 91189 | HEALTH NET | $141K | — | $141K | 1.99% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $117 | $117 | 0.03% |
| VARIOUS - SEE ATTACHED3 Filed as: VARIOUS AGENTS C/O AFLAC* | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $12K | $532 | $12K | 14.78% |
| CHRISTA G AUFDEMBERG INC4 | 13102 BRITTANY WOODS DR TUSTIN, CA 92780 | PRE-PAID LEGAL SERVICES INC DBA LEGAL SHIELD | $1K | — | $1K | 9.66% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | 18101 VON KARMAN AVE STE 600 IRVINE, CA 92612 | PRE-PAID LEGAL SERVICES INC DBA LEGAL SHIELD | $864 | — | $864 | 5.86% |
| MULTIPLE AGENTS*3 | POST OFFICE BOX 427 COLUMBIA, SC 29202 | CONTINENTAL AMERICAN INSURANCE COMPANY | $603 | — | $603 | 14.33% |
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 | 613 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 12 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 631 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HEALTH NET | 463 | $7.1M |
| Dental | DELTA DENTAL OF CALIFORNIA | 537 | $667K |
| Vision | VISION SERVICE PLAN | 508 | $60K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 613 | $429K |
| Short-term disability(3 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 613 | $516K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 613 | $429K |
| Prescription drug | HEALTH NET | 463 | $7.1M |
| Other(4 contracts, 4 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 613 | $531K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 613 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.