| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC | 200 PUBLIC SQUARE 3760 CLEVELAND, OH 44114 | CALIFORNIA PHYSICIANS' SERVICE | — | $152K | $152K | 4.24% |
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS AND INS SVCS LLC | 1850 GATEWAY DR STE 700 SAN MATEO, CA 94404 | KAISER FOUNDATION HEALTH PLAN, INC. | $257 | — | $257 | 0.02% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST INC | 93245 NETWORK PLACE CHICAGO, IL 60673 | KAISER FOUNDATION HEALTH PLAN, INC. | $32 | — | $32 | 0.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST INC | 425 NORTH MARTINGALE ROAD SUITE 110 SCHAUMBURG, IL 60173 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $67K | $6K | $73K | 11.32% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC | 200 PUBLIC SQUARE 3760 CLEVELAND, OH 44114 | BLUE SHIELD OF CALIFORNIA LIFE HEALTH INSURANCE COMPANY | $967 | — | $967 | 12.41% |
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 | 323 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 328 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 380 | $4.7M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 367 | $646K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 367 | $646K |
| Life insurance(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 367 | $654K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 367 | $646K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 367 | $646K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 380 | $4.7M |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 367 | $654K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 380 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.