| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC | 300 S GRAND AVE #2000 LOS ANGELES, CA 90071 | FEDERAL INSURANCE COMPANY | $12K | — | $12K | 15.00% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC | PO BOX 28852 NEW YORK, NY 10087 | FOUR EVER LIFE INS CO. | $5K | — | $5K | 8.00% |
| ANTHEM INSURANCE COMPANIES, INC.3 Filed as: ANTHEM INSURANCE COMPANY | 120 MONUMENT CIR. INDIANAPOLIS, IN 46204 | FOUR EVER LIFE INS CO. | — | $3K | $3K | 4.00% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC. | COMMISSION LOCKBOX28852 P.O. BOX 28852 NEW YORK, NY 10087 | HYATT LEGAL PLANS | $5K | — | $5K | 9.91% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC. | D/B/A WATSON WYATT WORLDWIDE, INC. LOCKBOX #741909, P.O. BOX 741909 ATLANTA, GA 303741909 | HYATT LEGAL PLANS | — | $962 | $962 | 2.09% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE | 300 S GRAND AVE #2000 LOS ANGELES, CA 90071 | FEDERAL INSURANCE COMPANY | $6K | — | $6K | 15.00% |
| KIMBERLY P HICKMAN3 | 600 UNIVERSITY STREET SUITE 3100 SEATTLE, WA 98101 | ZURICH AMERICAN LIFE INSURANCE COMPANY | $598 | — | $598 | 7.25% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $147 | — | $147 | 6.98% |
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 | 1,452 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 317 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,769 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 1,466 | $2.6M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1 | $2K |
| Life insurance(2 contracts, 2 carriers) | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 1,734 | $714K |
| Long-term disability(2 contracts, 2 carriers) | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 1,450 | $273K |
| Prescription drug(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC. | 440 | $2.5M |
| Other(5 contracts, 4 carriers) | FEDERAL INSURANCE COMPANY | 1,466 | $197K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,734 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.