| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OR CA INC. | PO BOX 101162 PASADENA, CA 91189 | KAISER FOUNDATION HEALTH PLAN INC. | $65K | — | $65K | 1.43% |
| SEQUOIA BENEFITS & INS SVCS LLC3 | 1850 GATEWAY DRIVE SUITE 700 SAN MATEO, CA 94404 | KAISER FOUNDATION HEALTH PLAN INC. | $65K | $5 | $65K | 1.43% |
| SEQUOIA BENEFITS & INS SVCS LLC3 | 1850 GATEWAY DRIVE SUITE 600 SAN MATEO, CA 94404 | CALIFORNIA PHYSICIANS' SERVICE | — | $48K | $48K | 1.55% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS OF CALIFORNIA | 18101 VON KARMAN AVE STE 600 IRVINE, CA 92612 | CALIFORNIA PHYSICIANS' SERVICE | — | $48K | $48K | 1.54% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS OF CALIFORNIA | PO BOX 101162 PASADENA, CA 91189 | KAISER FOUNDATION HEALTH PLAN INC. | $19K | — | $19K | 1.68% |
| SEQUOIA BENEFITS & INS SVCS LLC3 | 1850 GATEWAY DRIVE SUITE 700 SAN MATEO, CA 94404 | KAISER FOUNDATION HEALTH PLAN INC. | $14K | $1 | $14K | 1.24% |
| WILLISTOWERS WATSON INS SVCS W INC3 | PO BOX 101162 PASADENA, CA 91189 | DELTA DENTAL OF CALIFORNIA | $11K | — | $11K | 1.57% |
| SEQUOIA BENEFITS & INS SVCS LLC3 | 1850 GATEWAY DRIVE SUITE 700 SAN MATEO, CA 94404 | DELTA DENTAL OF CALIFORNIA | $11K | — | $11K | 1.55% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS W INC | 345 CALIFORNIA ST 20TH FLOOR SAN FRANCISCO, CA 94104 | BLUE CROSS BLUE SHIELD OF ARIZONA | $5K | — | $5K | 1.59% |
| SEQUOIA BENEFITS & INS SVCS LLC3 | 1850 GATEWAY DRIVE SUITE 700 SAN MATEO, CA 94404 | BLUE CROSS BLUE SHIELD OF ARIZONA | $3K | — | $3K | 1.11% |
| WILLIS TOWERS WATSON US LLC3 | PO BOX 28852 NEW YORK, NY 10087 | STANDARD INSURANCE COMPANY | — | $3K | $3K | 1.43% |
| WILLISTOWERS WATSON INS SVCS W INC3 | PO BOX 101162 PASADENA, CA 91189 | VISION SERVICE PLAN | $2K | — | $2K | 2.12% |
| SEQUOIA BENEFITS & INS SVCS LLC3 | 1850 GATEWAY DRIVE SUITE 600 SAN MATEO, CA 94404 | VISION SERVICE PLAN | $651 | — | $651 | 0.89% |
| WILLISTOWERS WATSON INS SVCS W INC3 | ONE BUSH ST 9TH FLOOR SAN FRANCISCO, CA 94104 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $668 | — | $668 | 1.50% |
| GREGORY S GOLUB3 | 1850 GATEWAY DRIVE SUITE 600 SAN MATEO, CA 94404 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $489 | — | $489 | 1.10% |
| WILLIS TOWERS WATSON US LLC3 | PO BOX 28852 NEW YORK, NY 10087 | STANDARD INSURANCE COMPANY | — | $471 | $471 | 1.38% |
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 | 1,125 | 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) | 1,131 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 690 | $9.1M |
| Dental | DELTA DENTAL OF CALIFORNIA | 1,701 | $706K |
| Vision | VISION SERVICE PLAN | 735 | $73K |
| Life insurance | STANDARD INSURANCE COMPANY | 1,220 | $212K |
| Long-term disability | STANDARD INSURANCE COMPANY | 1,169 | $34K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 495 | $3.4M |
| Other(2 contracts) | STANDARD INSURANCE COMPANY | 1,220 | $246K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,701 | — |
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."
No prospect flags tripped on this filing.