| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA - S.F. | 525 MARKET ST, SUITE 3400 SAN FRANCISCO, CA 94105 | KAISER FOUNDATION HEALTH PLAN INC. | $134K | — | $134K | 1.32% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL LIMITED | 600 CORPORATE POINTE, SUITE 600 CULVER CITY, CA 90230 | KAISER FOUNDATION HEALTH PLAN INC. | $67K | — | $67K | 0.66% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA - S.F. | 525 MARKET ST, SUITE 3400 SAN FRANCISCO, CA 94105 | KAISER FOUNDATION HEALTH PLAN INC. | $43K | — | $43K | 1.38% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL LIMITED | 600 CORPORATE POINTE, SUITE 600 CULVER CITY, CA 90230 | KAISER FOUNDATION HEALTH PLAN INC. | $20K | — | $20K | 0.64% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | PO BOX 101162 PASADENA, CA 91189 | METROPOLITAN LIFE INSURANCE COMPANY | $10K | $1K | $11K | 1.34% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL LIMITED | 600 CORPORATE POINTE, SUITE 600 CULVER CITY, CA 90230 | METROPOLITAN LIFE INSURANCE COMPANY | $395 | $66 | $461 | 0.06% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | PO BOX 101162 PASADENA, CA 91189 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $30K | — | $30K | 5.21% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL LIMITED | 600 CORPORATE POINTE, SUITE 600 CULVER CITY, CA 90230 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $13K | — | $13K | 2.34% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | PO BOX 101162 PASADENA, CA 91189 | VISION SERVICE PLAN | $2K | — | $2K | 1.55% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL LIMITED | 600 CORPORATE POINTE, SUITE 600 CULVER CITY, CA 90230 | VISION SERVICE PLAN | $2K | — | $2K | 1.33% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | PO BOX 101162 PASADENA, CA 91189 | METLIFE LEGAL PLANS | $4K | $530 | $5K | 9.93% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL LIMITED | 600 CORPORATE POINTE, SUITE 600 CULVER CITY, CO 90230 | METLIFE LEGAL PLANS | $630 | $128 | $758 | 1.54% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL LIMITED | 600 CORPORATE POINTE, SUITE 600 CULVER CITY, CA 90230 | METROPOLITAN GENERAL INSURANCE COMPANY | $2K | $193 | $3K | 14.62% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | 62877 COLLECTIONS DR CHICAGO, IL 60693 | METROPOLITAN GENERAL INSURANCE COMPANY | — | $216 | $216 | 1.20% |
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 | 133 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 137 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC. | 962 | $13.2M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 0 | $825K |
| Vision | VISION SERVICE PLAN | 921 | $156K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 1,332 | $574K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 1,332 | $574K |
| Prescription drug(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC. | 962 | $13.2M |
| Other(3 contracts, 3 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 1,332 | $641K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,332 | — |
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.