| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | 1350 TREAT BL SUITE 550 WALNUT CREEK, CA 94597 | FEDERAL INSURANCE COMPANY | $15K | — | $15K | 11.09% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC | 300 S GRAND AVE #2000 LOS ANGELES, CA 90071 | FEDERAL INSURANCE COMPANY | $5K | — | $5K | 3.91% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS. SERVICES, USA, INC | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $6K | — | $6K | 5.06% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $2K | — | $2K | 1.94% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | — | LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 5.29% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC | — | LIFE INSURANCE COMPANY OF AMERICA | $380 | — | $380 | 1.71% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | 1350 TREAT BLVD #550 WALNUT CREEK, CA 94597 | FEDERAL INSURANCE COMPANY | — | — | $0 | — |
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 | 1,510 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 283 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 212 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,005 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 2,568 | $4.0M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 4 | $111K |
| Life insurance(2 contracts, 2 carriers) | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 1,788 | $953K |
| Long-term disability(2 contracts, 2 carriers) | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 1,507 | $412K |
| Prescription drug(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC. | 500 | $3.8M |
| Other(6 contracts, 4 carriers) | FEDERAL INSURANCE COMPANY | 2,568 | $307K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,568 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.