| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF CALIFORNIA, INC. | 801 SOUTH FIGUEROA STREET SUITE 800 LOS ANGELES, CA 90017 | UNITEDHEALTHCARE INSURANCE COMPANY | $58K | $0 | $58K | 1.32% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF CALIFORNIA, INC. | 18101 VON KARMAN AVENUE SUITE 600 IRVINE, CA 92612 | CALIFORNIA PHYSICIANS SERVICE | $10 | $20K | $20K | 1.55% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 500 NORTH SANTA FE VISALIA, CA 93292 | CALIFORNIA PHYSICIANS SERVICE | $5 | $9K | $9K | 0.68% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF CALIFORNIA, INC. | 801 SOUTH FIGUEROA STREET SUITE 800 LOS ANGELES, CA 90017 | KAISER FOUNDATION HEALTH PLAN INC | $16K | $0 | $16K | 3.48% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD SUITE 600 GLENDALE, CA 91203 | KAISER FOUNDATION HEALTH PLAN INC | $5K | $0 | $5K | 1.12% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF CALIFORNIA, INC. | PO BOX 101162 PASADENA, CA 91189 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $15K | $3K | $17K | 5.60% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $0 | $3K | 0.95% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF CALIFORNIA, INC. | PO BOX 101162 PASADENA, CA 91189 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $3K | $0 | $3K | 7.90% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD GLENDALE, CA 91203 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $727 | $0 | $727 | 2.22% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK, INC. | 200 LIBERTY STREET NEW YORK, NY 10281 | FEDERAL INSURANCE COMPANY | $2K | $0 | $2K | 25.01% |
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 | 463 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 463 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 939 | $6.2M |
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 939 | $4.4M |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 615 | $33K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 90 | $306K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 90 | $306K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 90 | $306K |
| Prescription drug(3 contracts, 3 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 939 | $6.2M |
| Other(3 contracts, 3 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 939 | $4.7M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 939 | — |
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.