| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC | COMMISSIONS LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 100878852 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $98K | — | $98K | 1.16% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC | COMMISSIONS LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 100878852 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $48K | — | $48K | 0.57% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC | COMMISSIONS LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 100878852 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $30K | — | $30K | 0.36% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC | LOCKBOX #741900, PO BOX 741909 ATLANTA, GA 303741909 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $63K | $72K | $136K | 2.66% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON PENNSYLVANIA INC. | LOCKBOX #9102 PO BOX 8500 PHILADELPHIA, PA 19178 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | — | $18K | $18K | 0.36% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC | PO BOX 28852 NEW YORK, NY 100878852 | VISION SERVICE PLAN | $62K | — | $62K | 2.75% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON PENNSYLVANIA INC | PO BOX 8500 STOP 9102 PHILADELPHIA, PA 191789102 | VISION SERVICE PLAN | $6K | — | $6K | 0.25% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC | COMMISSIONS LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 100878852 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $98K | — | $98K | 6.95% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC | COMMISSIONS LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 100878852 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $48K | — | $48K | 3.40% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC | COMMISSIONS LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 100878852 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $30K | — | $30K | 2.13% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC | COMMISSIONS LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 100878852 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $98K | — | $98K | 10.17% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC | COMMISSIONS LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 100878852 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $48K | — | $48K | 4.98% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC | COMMISSIONS LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 100878852 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $30K | — | $30K | 3.12% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC | LOCKBOX #741909, PO BOX 741909 ATLANTA, GA 303741909 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $346 | $401 | $747 | 3.10% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON PENNSYLVANIA, INC | LOCKBOX #9102, PO BOX 8500 PHILADELPHIA, PA 191789102 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | — | $37 | $37 | 0.15% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC | LOCKBOX #741909 PO BOX 741909 ATLANTA, GA 303741909 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $12 | — | $12 | 1.44% |
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 | 16,240 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 99 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 16,339 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts) | KAISER FOUNDATION HEALTH PLAN INC. | 11,291 | $59.5M |
| Vision | VISION SERVICE PLAN | 9,998 | $2.3M |
| Life insurance(2 contracts) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 18,510 | $9.9M |
| Short-term disability(2 contracts) | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 83 | $25K |
| Long-term disability | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 16,131 | $5.1M |
| Prescription drug(4 contracts) | KAISER FOUNDATION HEALTH PLAN INC. | 11,291 | $59.5M |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 9,206 | $963K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 18,510 | — |
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.