| 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 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $218K | $180 | $219K | 3.44% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC. | LOCKBOX #28852, PO BOX 28852 NEW YORK, NY 100878852 | KAISER FOUNDATION HEALTH PLAN INC | $68K | — | $68K | 1.83% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC. | LOCKBOX #28852, PO BOX 28852 NEW YORK, NY 100878852 | CIGNA HEALTHCARE OF CALIFORNIA | $50K | — | $50K | 2.70% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC. | LOCKBOX #28852, PO BOX 28852 NEW YORK, NY 100878852 | DELTA DENTAL OF CALIFORNIA | $18K | — | $18K | 1.80% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE, INC. | LOCKBOX #28852, PO BOX 28852 NEW YORK, NY 100878852 | HARTFORD LIFE AND ACCIDENT | $83K | $14K | $97K | 11.68% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS INC | 2 PIERCE PLACE 21ST FL ITASCA, IL 601433141 | HARTFORD LIFE AND ACCIDENT | $0 | $22 | $22 | 0.00% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC | LOCKBOX #28852, PO BOX 28852 NEW YORK, NY 100878852 | KAISER FOUNDATION HEALTH PLAN INC | $7K | — | $7K | 1.77% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC. | LOCKBOX #28852, PO BOX 28852 NEW YORK, NY 100878852 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $27K | — | $27K | 10.00% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC. | LOCKBOX #28852, PO BOX 28852 NEW YORK, NY 100878852 | HARTFORD LIFE AND ACCIDENT | $3K | $523 | $4K | 11.71% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK, INC | 200 LIBERTY ST 7TH FLOOR NEW YORK, NY 10281 | NATIONAL UNION FIRE INS. CO. OF PITTSBURGH, PA | $7K | — | $7K | 25.00% |
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 | 827 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 34 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 11 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 872 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(6 contracts, 5 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,072 | $13.0M |
| Dental(3 contracts, 2 carriers) | DELTA DENTAL OF CALIFORNIA | 1,981 | $1.3M |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 914 | $832K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 914 | $832K |
| Prescription drug(5 contracts, 4 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,072 | $11.2M |
| Other(6 contracts, 5 carriers) | HARTFORD LIFE AND ACCIDENT | 934 | $1.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,981 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.