| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE | PO BOX 101162 PASADENA, CA 91189 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $9K | $46K | $54K | 2.98% |
| WILLIS TOWERS WATSON US LLC3 | COMMISSION LOCKBOX 28852 P O BOX 28852 NEW YORK, NY 10087 | AETNA LIFE INSURANCE CO. | $79K | — | $79K | 37.44% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | 2010 MAIN ST SUITE 1050 IRVINE, CA 92614 | AETNA LIFE INSURANCE CO. | $23K | — | $23K | 11.03% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS ADMIN LLC | 1 INVESTORS WAY MAILSTOP N-5-C NORWOOD, MA 02062 | AETNA LIFE INSURANCE CO. | $11K | — | $11K | 5.11% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | PO BOX 101162 PASADENA, CA 91189 | ARAG INSURANCE COMPANY | $6K | — | $6K | 8.28% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | ARAG INSURANCE COMPANY | $590 | — | $590 | 0.79% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 777 108TH AVE. NE STE 200 BELLEVUE, WA 98004 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $4K | — | $4K | 10.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | 801 SOUTH FIGUEROA STREET LOS ANGELES, CA 90017 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $919 | — | $919 | 3.50% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS, LLC | 4565 PAYSHPHERE CIRCLE CHICAGO, IL 60674 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $173 | — | $173 | 0.66% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | ACE AMERICAN INSURANCE COMPANY | $4K | — | $4K | 20.00% |
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 | 1,985 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 15 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 87 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,087 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 609 | $3.3M |
| Vision | VISION SERVICE PLAN | 1,650 | $535K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,139 | $1.8M |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,139 | $1.8M |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,139 | $1.8M |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 609 | $3.2M |
| Other(4 contracts, 4 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,139 | $2.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,139 | — |
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.