| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON NORTHEAST, INC | JP MORGAN CHASE, PO BOX 4557 NEW YORK, NY 10249 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $111K | — | $111K | 1.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE | 4250 EXECUTIVE SQUARE, SUITE 900 LA JOLLA, CA 92037 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $56K | $27K | $83K | 5.15% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS NORTHEAST, LLC | 445 HAMILTON AVENUE, 10TH FLOOR WHITE PLAINS, NY 10601 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | — | $435 | $435 | 0.03% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS. SVCS OF CA, INC.-S.F. | 525 MARKET ST, STE 3400 SAN FRANCISCO, CA 94105 | KAISER FOUNDATION HEALTH PLAN INC. | $51K | — | $51K | 3.15% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE | 4250 EXECUTIVE SQUARE, SUITE 900 LA JOLLA, CA 92037 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 9.00% |
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 | 1,124 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 13 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 12 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,149 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 829 | $12.7M |
| Dental(2 contracts) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,153 | $1.7M |
| Vision(2 contracts) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,153 | $1.7M |
| Life insurance(2 contracts) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,153 | $1.7M |
| Short-term disability(2 contracts) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,153 | $1.7M |
| Long-term disability(2 contracts) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,153 | $1.7M |
| Prescription drug(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 829 | $12.7M |
| Other(2 contracts) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,153 | $1.7M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,153 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.