| 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 | $10K | $33K | $43K | 1.88% |
| WILLIS TOWERS WATSON US LLC3 | COMMISSION LOCKBOX 28852 P O BOX 28852 NEW YORK, NY 10087 | AETNA LIFE INSURANCE CO. | $74K | — | $74K | 32.75% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS ADMIN LLC | 12421 MEREDITH DR URBANDALE, IA 50398 | AETNA LIFE INSURANCE CO. | $7K | — | $7K | 3.08% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | 2010 MAIN ST SUITE 1050 IRVINE, CA 10087 | AETNA LIFE INSURANCE CO. | -$74K | — | -$74K | -32.75% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 777 108TH AVE. NE STE 200 BELLEVUE, WA 98004 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $6K | — | $6K | 10.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | 38 EASTWOOD DRIVE SUITE 300 SOUTH BURLINGTON, VT 05403 | KAISER FOUNDATION HEALTH PLAN, INC. | $967 | — | $967 | 3.35% |
| 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 | 1,745 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 127 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 54 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,926 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 618 | $3.4M |
| Vision | VISION SERVICE PLAN | 1,469 | $508K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,919 | $2.3M |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,919 | $2.3M |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,919 | $2.3M |
| Prescription drug(2 contracts) | KAISER FOUNDATION HEALTH PLAN, INC. | 618 | $3.3M |
| Other(4 contracts, 4 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,919 | $2.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,919 | — |
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."
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.