| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA INC. | PO BOX 101162 PASADENA, CA 91189 | KAISER FOUNDATION HEALTH PLAN INC. | $99K | $2 | $99K | 3.30% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS OF CA, INC. | 18101 VON KARMAN AVE STE 600 IRVINE, CA 92612 | CALIFORNIA PHYSICIANS' SERVICE | $72K | $17K | $89K | 3.69% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA INC. | PO BOX 101162 PASADENA, CA 91189 | KAISER FOUNDATION HEALTH PLAN INC. | $30K | $1 | $30K | 3.30% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA, INC. | 801 S FIGUEROA STREET SUITE 800 LOS ANGELES, CA 90017 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $37K | — | $37K | 4.24% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA, INC. | 444 MARKET ST STE 1600 SAN FRANCISCO, CA 94111 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $9K | — | $9K | 1.07% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA | 345 CALIFORNIA ST 20TH FLOOR SAN FRANCISCO, CA 94104 | BLUE CROSS BLUE SHIELD OF ARIZONA | $9K | $1K | $10K | 4.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA INC | ONE BUSH ST 9TH FLOOR SAN FRANCISCO, CA 94104 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $513 | — | $513 | 2.07% |
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 | 1,053 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 11 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 50 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,114 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(6 contracts, 5 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 641 | $6.6M |
| Dental | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 789 | $883K |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 789 | $883K |
| Life insurance | STANDARD INSURANCE COMPANY | 1,092 | $173K |
| Long-term disability | STANDARD INSURANCE COMPANY | 1,044 | $27K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 212 | $2.7M |
| Other | STANDARD INSURANCE COMPANY | 1,092 | $173K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,092 | — |
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.