| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA | 18101 VON KARMAN AVE STE 600 IRVINE, CA 92612 | CALIFORNIA PHYSICIANS SERVICE | $209K | $10K | $219K | 1.55% |
| SEQUOIA BENEFITS & INS SVCS LLC3 | 1850 GATEWAY DR STE 600 SAN MATEO, CA 944044060 | CALIFORNIA PHYSICIANS SERVICE | $144K | — | $144K | 1.02% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA | PO BOX 101162 PASADENA, CA 91189 | KAISER FOUNDATION HEALTH PLAN INC | $74K | — | $74K | 1.86% |
| SEQUOIA BENEFITS & INS SVCS LLC3 | 1850 GATEWAY DRIVE, SUITE 600 SAN MATEO, CA 944044060 | KAISER FOUNDATION HEALTH PLAN INC | $60K | — | $60K | 1.51% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA | PO BOX 101162 PASADENA, CA 91189 | METROPOLITAN LIFE INSURANCE COMPANY | — | $15K | $15K | 1.18% |
| SEQUOIA BENEFITS & INS SVCS LLC3 | 1850 GATEWAY DRIVE, SUITE 600 SAN MATEO, CA 94404 | METROPOLITAN LIFE INSURANCE COMPANY | — | $21 | $21 | 0.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA | PO BOX 101162 PASADENA, CA 91189 | HARTFORD LIFE AND ACCIDENT | — | $49K | $49K | 6.62% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA | PO BOX 101162 PASADENA, CA 91189 | VISION SERVICE PLAN | $2K | — | $2K | 1.10% |
| SEQUOIA BENEFITS & INS SVCS LLC3 | 1850 GATEWAY DRIVE, SUITE 600 SAN MATEO, CA 94404 | VISION SERVICE PLAN | $2K | — | $2K | 0.90% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA | PO BOX 101162 PASADENA, CA 91189 | SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION | — | $204 | $204 | 1.18% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK, INC. | 200 LIBERTY STREET, 7TH FLOOR NEW YORK, NY 10281 | NATIONAL UNION FIRE INS. CO. OF PITTSBURGH, PA | $638 | — | $638 | 5.00% |
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 | 1,053 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,053 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 1,920 | $18.1M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 2,465 | $1.3M |
| Vision | VISION SERVICE PLAN | 1,009 | $205K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 1,149 | $733K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 1,149 | $733K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 1,149 | $733K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 1,920 | $18.1M |
| Other(3 contracts, 3 carriers) | HARTFORD LIFE AND ACCIDENT | 1,392 | $781K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,465 | — |
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."
No prospect flags tripped on this filing.