| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SERVICES OF CA | 525 MARKET ST STE 3400 SAN FRANCISCO, CA 94105 | KAISER FOUNDATION HEALTH PLAN INC | $86K | — | $86K | 3.52% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | PO BOX 731739 DALLAS, TX 75373 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $142K | — | $142K | 9.02% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SRVS WEST | PO BOX 101162 PASADENA, CA 91189 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $14K | $14K | 0.89% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SERVICES OF CA | 525 MARKET ST STE 3400 SAN FRANCISCO, CA 94105 | KAISER FOUNDATION HEALTH PLAN INC | $17K | — | $17K | 3.95% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | 801 S FIGUEROA ST STE 800 LOS ANGELES, CA 90017 | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC | $7K | — | $7K | 3.07% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | PO BOX 101162 PASADENA, CA 91189 | VISION SERVICE PLAN | $5K | — | $5K | 1.92% |
| MJ INSURANCE3 Filed as: VARIOUS AGENTS-SEE ATTACHMENT | PO BOX 1365 COLUMBIA, SC 29202 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $27K | $21K | $49K | 26.81% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | 801 S FIGUEROA STREET SUITE 800 LOS ANGELES, CA 90017 | KAISER FOUNDATION HEALTH PLAN OF COLORADO | $2K | — | $2K | 2.08% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SRVS WEST | ONE BUSH ST 9TH FLOOR SAN FRANCISCO, CA 94104 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $3K | — | $3K | 3.38% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | 801 SOUTH FIGUEROA ST STE 800 LOS ANGELES, CA 90017 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $2K | — | $2K | 3.55% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | 801 S FIGUEROA ST STE 800 LOS ANGELES, CA 90017 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $393 | — | $393 | 3.47% |
| MJ INSURANCE3 Filed as: VARIOUS AGENTS-SEE ATTACHMENT | PO BOX 1365 COLUMBIA, SC 29202 | THE PAUL REVERE LIFE INSURANCE COMPANY | $91 | $88 | $179 | 79.91% |
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 | 2,077 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 17 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 183 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,277 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(10 contracts, 9 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 283 | $3.7M |
| Dental | HAWAII MEDICAL SERVICE ASSOCIATION | 18 | $166K |
| Vision(2 contracts, 2 carriers) | VISION SERVICE PLAN | 1,652 | $409K |
| Life insurance(3 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 2,077 | $1.8M |
| Short-term disability(3 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 2,077 | $1.8M |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 2,077 | $1.6M |
| Prescription drug(8 contracts, 7 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 283 | $3.5M |
| Other(3 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 2,077 | $1.8M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,077 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.