| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS OF CA | LOCK BOX 100485 BANC ONE DEPT 100485 PASADENA, CA 91189 | AETNA LIFE INSURANCE COMPANY | $292K | — | $292K | 1.60% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SERVICES OF CA INC | PO BOX 101162 PASADENA, CA 91189 | KAISER FOUNDATION HEALTH PLAN INC. | $3K | — | $3K | 0.10% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS OF CA | LOCK BOX 100485 BANC ONE DEPT 100485 PASADENA, CA 91189 | AETNA HEALTH, INC. | $39K | — | $39K | 1.60% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SERVICES OF CA INC | PO BOX 101162 PASADENA, CA 91189 | METROPOLITAN LIFE INSURANCE COMPANY | — | $25 | $25 | 0.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS OF CA | 18101 VON KARMAN AVE, SUITE 600 IRVINE, CA 92612 | HARTFORD LIFE AND ACCIDENT | — | $15K | $15K | 0.90% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS OF CA | ONE BUSH STREET, 9TH FLOOR SAN FRANCISCO, CA 94104 | HARTFORD LIFE AND ACCIDENT | — | $2K | $2K | 1.03% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: ARTHUR J GALLAGHER AND CO | INS BROKERS OF CA 1255 BATTERY ST,#450 SAN FRANCISCO, CA 94111 | FEDERAL INSURANCE COMPANY | $8K | $52 | $8K | 15.10% |
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 | 1,588 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 44 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,632 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | AETNA LIFE INSURANCE COMPANY | 2,922 | $23.4M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 3,726 | $2.1M |
| Vision | VISION SERVICE PLAN | 1,488 | $280K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 1,695 | $1.7M |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 1,695 | $1.7M |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 1,695 | $1.7M |
| Other(4 contracts, 4 carriers) | HARTFORD LIFE AND ACCIDENT | 3,676 | $340K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,726 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.