| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS OF CA INC. | 18101 VON KARMAN AVENUE, SUITE 600 IRVINE, CA 92612 | KAISER FOUNDATION HEALTH PLAN INC. | — | $161 | $161 | 0.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS OF CA INC. | 18101 VON KARMAN AVENUE, SUITE 600 IRVINE, CA 92612 | KAISER FOUNDATION HEALTH PLAN INC. | — | $41 | $41 | 0.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA INC | 18101 VON KARMAN AVENUE, SUITE 600 IRVINE, CA 92612 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $29K | $6K | $35K | 11.91% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS | 897 12TH STREET HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $2K | $6K | 4.30% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS. OF CA, INC. | 18101 VON KARMAN AVENUE, SUITE 600 IRVINE, CA 92612 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $394 | $3K | 2.03% |
| AON CONSULTING INC3 Filed as: AON CONSULTING & INS SVCS | PO BOX 905494 CHARLOTTE, NC 28290 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $847 | — | $847 | 0.62% |
| SMARTBEN, INC C/O HODGES-MACE LLC3 | 5775-E GLENRIDGE DRIVE, SUITE 500 ATLANTA, GA 30328 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $376 | — | $376 | 0.28% |
| F.B.P. INSURANCE SERVICES, LLC3 Filed as: F.B.P INSURANCE SERVICES LLC | 414 GALLIMORE DAIRY ROAD, SUITE F GREENSBORO, NC 27409 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $53 | — | $53 | 0.04% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS. OF CA, INC. | 18101 VON KARMAN AVE., 6TH FLOOR IRVINE, CA 92612 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $10K | $2K | $12K | 12.01% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS OF CA INC | 18101 VON KARMAN AVE., 6TH FLOOR IRVINE, CA 92612 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $1K | $7K | 11.43% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS | 897 12TH STREET HAMMONTON, NJ 08037 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $1 | $2K | 3.34% |
| SMARTBEN, INC C/O HODGES-MACE LLC3 | 5775-E GLENRIDGE DRIVE, SUITE 500 ATLANTA, GA 30328 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 1.81% |
| AON CONSULTING INC3 Filed as: AON CONSULTING | PO BOX 905494 CHARLOTTE, NC 28290 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $394 | — | $394 | 0.61% |
| F.B.P. INSURANCE SERVICES, LLC3 Filed as: F.B.P. INSURANCE SERVICES, INC. | 414 GALLIMORE DAIRY ROAD, SUITE F GREENSBORO, NC 27409 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6 | — | $6 | 0.01% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS. OF CA, INC. | 18101 VON KARMAN AVE., 6TH FLOOR IRVINE, CA 92612 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $357 | $2K | 12.03% |
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 | 1,342 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 16 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,358 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 1,018 | $13.6M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 452 | $62K |
| Vision | VISION SERVICE PLAN | 1,062 | $92K |
| Life insurance(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,357 | $426K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 489 | $100K |
| Prescription drug(3 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 1,018 | $13.6M |
| Other(3 contracts, 3 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 1,357 | $219K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,357 | — |
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."
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.