| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | DUNNING SERIES DEPT 3042 P.O. BOX 123042 DALLAS, TX 753123042 | CIGNA HEALTH AND LIFE INSURANCE CO. AND AFFILIATES | — | $38K | $38K | 1.93% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SVCS USA, INC. | 1350 TREAT BLVD, STE 550 WALNUT CREEK, CA 94597 | UNUM | $10K | — | $10K | 4.32% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SVCS USA, INC. | 150 N MICHIGAN AVE, STE 3900 CHICAGO, IL 60601 | UNUM | — | $10K | $10K | 4.32% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE, INC. | LOCKBOX #28852 NEW YORK, NY 10087 | UNUM | — | $8K | $8K | 3.31% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON PENNSYLVANIA, INC. | PO BOX 8500 LOCKBOX #9102 LOCKBOX, PA 191789102 | UNUM | $835 | — | $835 | 0.36% |
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 | 328 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 334 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 358 | $5.0M |
| Dental | DELTA DENTAL OF CALIFORNIA | 326 | $367K |
| Vision(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 245 | $3.0M |
| Life insurance | UNUM | 358 | $232K |
| Long-term disability | UNUM | 358 | $232K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN, INC. | 245 | $3.0M |
| Other(2 contracts, 2 carriers) | UNUM | 358 | $243K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 358 | — |
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.