| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC | LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 100878852 | FEDERAL INSURANCE COMPANY | $12K | — | $12K | 13.88% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC | LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 100878852 | FOUR EVER LIFE INS CO. | $4K | — | $4K | 8.00% |
| ANTHEM INSURANCE COMPANIES, INC.3 Filed as: ANTHEM INSURANCE COMPANY | 120 MONUMENT CIR. INDIANAPOLIS, IN 46204 | FOUR EVER LIFE INS CO. | — | $2K | $2K | 4.00% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC. | COMMISSION LOCKBOX 28852 P.O. BOX 28852 NEW YORK, NY 100878852 | HYATT LEGAL PLANS | $4K | — | $4K | 9.99% |
| KIMBERLY P HICKMAN3 | 600 UNIVERSITY STREET SUITE 3100 SEATTLE, WA 98101 | ZURICH AMERICAN LIFE INSURANCE COMPANY | $746 | — | $746 | 6.32% |
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 | 1,260 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 337 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,597 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 1,266 | $2.9M |
| Life insurance(2 contracts, 2 carriers) | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 1,547 | $673K |
| Long-term disability(2 contracts, 2 carriers) | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 1,257 | $250K |
| Prescription drug(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC. | 446 | $2.8M |
| Other(4 contracts, 3 carriers) | FEDERAL INSURANCE COMPANY | 1,266 | $157K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,547 | — |
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.