| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | PO BOX 101162 PASADENA, CA 91189 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $279K | $8K | $288K | 1.55% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA, INC. | PO BOX 101162 PASADENA, CA 91189 | KAISER FOUNDATION HEALTH PLAN INC | $42K | — | $42K | 1.58% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA, INC. | PO BOX 101162 PASADENA, CA 91189 | KAISER FOUNDATION HEALTH PLAN INC | $32K | — | $32K | 1.50% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SERVICES | 525 MARKET STREET SUITE 3400 SAN FRANCISCO, CA 94105 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $23K | — | $23K | 7.18% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE | PO BOX 101162 PASADENA, CA 91189 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $9K | — | $9K | 2.82% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SERVICES | 525 MARKET STREET SUITE 3400 SAN FRANCISCO, CA 94105 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $19K | — | $19K | 6.77% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE | PO BOX 101162 PASADENA, CA 91189 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $9K | — | $9K | 3.23% |
| 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 | — | $80 | $80 | 0.03% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | PO BOX 101162 PASADENA, CA 91189 | VISION SERVICE PLAN | $4K | — | $4K | 2.01% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SERVICES | 525 MARKET STREET SUITE 3400 SAN FRANCISCO, CA 94105 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $9K | — | $9K | 7.19% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE | PO BOX 101162 PASADENA, CA 91189 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 2.81% |
| 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 MID-ATLANTIC | $801 | — | $801 | 1.22% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SERVICES | 525 MARKET STREET SUITE 3400 SAN FRANCISCO, CA 94105 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 6.93% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE | PO BOX 101162 PASADENA, CA 91189 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 3.07% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | UNKNOWN BRENTWOOD, CA 94513 | ACE AMERICAN INSURANCE COMPANY | $500 | — | $500 | 20.00% |
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 | 1,428 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 20 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 14 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,462 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(7 contracts, 5 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 887 | $24.6M |
| Dental(2 contracts) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 887 | $19.3M |
| Vision | VISION SERVICE PLAN | 1,371 | $203K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,428 | $277K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,428 | $122K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,428 | $322K |
| Prescription drug(6 contracts, 4 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 887 | $24.4M |
| Other(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,428 | $50K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,428 | — |
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.