| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA, INC. | 525 MARKET ST STE 3400 SAN FRANCISCO, CA 94105 | KAISER FOUNDATION HEALTH PLAN, INC. | $24K | — | $24K | 1.49% |
| 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 | $10K | — | $10K | 2.30% |
| 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 | $4K | — | $4K | 1.50% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | PO BOX 101162 PASADENA, CA 91189 | SUN LIFE ASSURANCE COMPANY OF CANADA | $9K | — | $9K | 5.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | 525 MARKET STREET STE 3400 SAN FRANCISCO, CA 94105 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $4K | $4K | 2.17% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | PO BOX 101162 PASADENA, CA 91189 | CIGNA HEALTHCARE OF CALIFORNIA | $23K | — | $23K | 16.56% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | PO BOX 101162 PASADENA, CA 91189 | DELTA DENTAL OF CALIFORNIA | $4K | — | $4K | 10.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE SVCS | PO BOX 101162 PASADENA, CA 91189 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $19 | $19 | — |
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 | 206 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 209 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 171 | $2.5M |
| Dental | DELTA DENTAL OF CALIFORNIA | 217 | $41K |
| Vision | VISION SERVICE PLAN | 199 | $33K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 137 | $187K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 137 | $187K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 171 | $2.0M |
| Other(5 contracts, 4 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 206 | $1.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 217 | — |
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.