| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC. | PO BOX 28852 NEW YORK, NY 10087 | KAISER FOUNDATION HEALTH PLAN INC | $17K | $0 | $17K | 0.46% |
| WILLIS TOWERS WATSON US LLC3 | FBO GLOBAL FOUNDRIES 1500 MARKET ST FL 20 PHILADELPHIA, PA 19102 | STANDARD INSURANCE COMPANY | $80K | — | $80K | 3.08% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL LLC | PO BOX 203383 DALLAS, TX 753203381 | STANDARD INSURANCE COMPANY | $31K | $7K | $39K | 1.49% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA INC | PO BOX 101162 PASADENA, CA 911891162 | STANDARD INSURANCE COMPANY | — | $7K | $7K | 0.29% |
| WILLIS TOWERS WATSON US LLC3 | PO BOX 28852 LOCKBOX 28852 NEW YORK, NY 10087 | HARTFORD LIFE AND ACCIDENT | $29K | $6K | $35K | 1.76% |
| USI INSURANCE SERVICES LLC3 | 201 MISSION ST STE 1100 SAN FRANCISCO, CA 94105 | HARTFORD LIFE AND ACCIDENT | $32K | — | $32K | 1.64% |
| USI INSURANCE SERVICES LLC3 | 470 PARK AVE SOUTH FLOOR 6 NEW YORK, NY 10016 | HARTFORD LIFE AND ACCIDENT | — | $10K | $10K | 0.49% |
| BUCK GLOBAL LLC3 Filed as: BUCK GLOBAL, LLC. | 353 SACRAMENTO STREET FLOOR 8 SAN FRANCISCO, CA 94111 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $12K | — | $12K | 5.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC. | PO BOX 28852 NEW YORK, NY 10087 | KAISER FOUNDATION HEALTH PLAN INC | $635 | — | $635 | 0.48% |
| BUCK GLOBAL LLC3 Filed as: BUCK GLOBAL, LLC | 255 CALIFORNIA STREET SUITE 550 SAN FRANCISCO, CA 94111 | NATIONAL UNION FIRE INS. CO. OF PITTSBURGH | $9K | — | $9K | 10.00% |
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 | 6,908 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 108 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 7,016 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 698 | $4.1M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 8 | $242K |
| Life insurance | STANDARD INSURANCE COMPANY | 6,908 | $2.6M |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 8,784 | $2.0M |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 8,784 | $2.0M |
| Prescription drug(3 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 698 | $4.1M |
| Other(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 6,908 | $332K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 8,784 | — |
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.