| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON PENNSYLVANIA INC | PO BOX 9102 PO BOX 8500 PHILADELPHIA, PA 191788500 | METROPOLITAN LIFE INSURANCE COMPANY | — | $31 | $31 | 0.06% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC | PO BOX 28852 NEW YORK, NY 100878852 | METROPOLITAN LIFE INSURANCE COMPANY | — | $31 | $31 | 0.06% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC | LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | — | $6K | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| VISION SERVICE PLAN EIN 06-1227840 NONE | Direct payment from the plan; Contract Administrator; Claims processing Service code 12 | — | $45K |
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 | 3,180 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 307 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 3,487 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 1,902 | $9.9M |
| Dental(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 2,066 | $2.6M |
| Life insurance | STANDARD INSURANCE COMPANY | 3,378 | $1.6M |
| Short-term disability(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 2,757 | $992K |
| Long-term disability | STANDARD INSURANCE COMPANY | 2,757 | $431K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 1,902 | $9.7M |
| Other(3 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 3,180 | $67K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,378 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.