| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALTERNATIVE RISK SOLUTIONS LLC3 | 101 2ND ST SUITE 100 PETALUMA, CA 94952 | SUN LIFE ASSURANCE COMPANY OF CANADA | $236K | — | $236K | 15.60% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC | PO BOX 28852 NEW YORK, NY 100878852 | METROPOLITAN LIFE INSURANCE COMPANY | — | $24K | $24K | 1.93% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC | PO BOX 28852 NEW YORK, NY 100878852 | METROPOLITAN LIFE INSURANCE COMPANY | — | $31 | $31 | 0.00% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON PENNSYLVANIA INC | PO BOX 9102 PO BOX 8500 PHILADELPHIA, PA 191788500 | METROPOLITAN LIFE INSURANCE COMPANY | — | $31 | $31 | 0.00% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC. | COMMISSION LOCKBOX 28852 P.O. BOX 28852 NEW YORK, NY 10087 | HYATT LEGAL PLANS | $14K | — | $14K | 10.72% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE, INC. | LOCKBOX #741909 P.O. BOX 741909 ATLANTA, GA 303741909 | HYATT LEGAL PLANS | — | $3K | $3K | 2.11% |
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 | 2,791 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 233 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 19 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 3,043 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC. | 287 | $1.8M |
| Vision | VISION SERVICE PLAN | 2,822 | $457K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 4,505 | $1.2M |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC. | 287 | $1.8M |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 2,530 | $1.5M |
| Other(4 contracts, 3 carriers) | MAGELLAN BEHAVIORAL HEALTH | 9,319 | $618K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 9,319 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.