| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PACIFIC RESOURCES BNFTS ADVSRS LLC | SUITE 635 21300 VICTORY BLVD WOODLAND HILLS, CA 91367 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $345K | — | $345K | 2.59% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $83K | — | $83K | 0.62% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PACIFIC RESOURCES BENEFITS ADV | 75 STATE ST STE 1710 BOSTON, MA 02109 | HARTFORD LIFE AND ACCIDENT | — | $105K | $105K | 1.65% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC. | PO BOX 28852 NEW YORK, NY 100878852 | KAISER FOUNDATION HEALTH PLAN INC. | $60K | — | $60K | 1.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC. | PO BOX 28852 NEW YORK, PA 100878852 | KAISER FOUNDATION HEALTH PLAN INC. | $31K | — | $31K | 1.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC | COMMISSION LOCKBOX #28852 P.O. BOX 28852 NEW YORK, NY 10087 | KAISER FOUNDATION HEALTH PLAN OF COLORADO | $30K | — | $30K | 1.01% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DE INC | LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $50K | $50K | 2.05% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC. | PO BOX 28852 NEW YORK, NY 100878852 | KAISER FOUNDATION HEALTH PLAN INC. | $14K | — | $14K | 1.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE | 1079 SOLUTIONS CENTER CHICAGO, IL 60677 | HEALTH ALLIANCE PLAN | $13K | — | $13K | 1.01% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC. | PO BOX 28852 NEW YORK, NY 100878852 | SELECTHEALTH | $12K | — | $12K | 1.01% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC. | 901 NORTH GLEBE ROAD SUITE 600 ARLINGTON, VA 22203 | HEALTH PLAN OF NEVADA/SIERRA HEALTH & LIFE | $26K | — | $26K | 3.03% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC. | 901 NORTH GLEBE ROAD SUITE 600 ARLINGTON, VA 22203 | HEALTH ALLIANCE MEDICAL PLANS | $14K | — | $14K | 1.62% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DE INC | COMMISSION LOCKBOX 28852 P.O. BOX 28852 NEW YORK, NY 10087 | UPMC HEALTH OPTIONS | $686 | — | $686 | 0.10% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DE INC | LOCKBOX #28852 PO BOX 28852 NEW YORK, NY 10087 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $17K | $17K | 2.73% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC.(LA) | LOCKBOX 28852 NEW YORK, NY 10087 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $2K | — | $2K | 1.02% |
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS OF CO LLC | 1873 S BELLAIR ST, STE 600 DENVER, CO 80222 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $6K | — | $6K | 3.47% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC. | 901 NORTH GLEBE ROAD SUITE 600 ARLINGTON, VA 22203 | HEALTH ALLIANCE MEDICAL PLANS | $3K | — | $3K | 3.44% |
| BENEFITS INC3 Filed as: BENEFITS INC. | 9301 S W FREEWAY, STE 270 HOUSTON, TX 77074 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $14K | — | $14K | 15.33% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PACIFIC RESOURCES BENEFITS ADV | C/O BEECHER CARLSON 75 STATE STE SUITE 1710 BOSTON, MA 02109 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $13K | — | $13K | 15.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DE INC. | COMMISSION LOCKBOX 28852 P.O. BOX 28852 NEW YORK, NC 10087 | UPMC HEALTH OPTIONS | $59 | — | $59 | 0.33% |
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 | 35,549 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1,078 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 778 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 37,405 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(15 contracts, 11 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 41,883 | $23.3M |
| Dental | HMSA HEALTH PLAN | 8 | $46K |
| Vision | VISION SERVICE PLAN | 27,606 | $4.9M |
| Life insurance(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 35,870 | $13.5M |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 346 | $185K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 85 | $87K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CARE NETWORK OF MICHIGAN | 611 | $4.2M |
| Other(7 contracts, 5 carriers) | HARTFORD LIFE AND ACCIDENT | 41,883 | $11.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 41,883 | — |
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.