| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA INC | PO BOX 101162 PASADENA, CA 91189 | KAISER FOUNDATION HEALTH PLAN INC | $48K | — | $48K | 1.64% |
| 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 | $27K | — | $27K | 3.74% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | PO BOX 101162 PASADENA, CA 91189 | CIGNA HEALTHCARE OF CALIFORNIA, INC. | $50K | — | $50K | 11.66% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVC WEST | PO BOX 101162 PASADENA, CA 91189 | SUN LIFE ASSURANCE COMPANY OF CANADA | $11K | $6K | $17K | 4.81% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA INC | PO BOX 101162 PASADENA, CA 91189 | DELTA DENTAL OF CALIFORNIA | $9K | — | $9K | 10.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS OF CALIFORNIA | PO BOX 101162 PASADENA, CA 91189 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $2K | — | $2K | 8.00% |
| ANDREINI & COMPANY3 | 1 MACARTHUR PLACE STE 100 SANTA ANA, CA 92707 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $145 | — | $145 | 0.54% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA INC | PO BOX 101162 PASADENA, CA 91189 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 8.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS | 525 MARKET STREET SUITE 3400 SAN FRANCISCO, CA 94105 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $396 | $23 | $419 | 15.86% |
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 | 492 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 6 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 506 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 427 | $4.1M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF CALIFORNIA | 543 | $116K |
| Vision | VISION SERVICE PLAN | 471 | $70K |
| Life insurance(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 493 | $357K |
| Long-term disability(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 493 | $357K |
| Prescription drug(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 408 | $3.7M |
| Other(4 contracts, 3 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 493 | $387K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 543 | — |
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."
No prospect flags tripped on this filing.