| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVC WEST | 801 SOUTH FIGUEROA ST STE 800 LOS ANGELES, CA 90017 | BLUE CROSS OF CALIFORNIA | $107K | — | $107K | 4.11% |
| WILLIS TOWERS WATSON US LLC3 | PO BOX 28852 NEW YORK, NY 10087 | BLUE CROSS OF CALIFORNIA | $12K | — | $12K | 0.44% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 425 CALIFORNIA STREET SUITE 2400 SAN FRANCISCO, CA 94104 | BLUE CROSS OF CALIFORNIA | -$287 | — | -$287 | -0.01% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA, INC. | PO BOX 101162 PASADENA, CA 91189 | KAISER FOUNDATION HEALTH PLAN INC | $115K | — | $115K | 4.90% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 425 CALIFORNIA ST STE 2400 SAN FRANCISCO, CA 94104 | KAISER FOUNDATION HEALTH PLAN INC | -$151 | $3K | $2K | 0.10% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | PO BOX 101162 PASADENA, CA 91189 | METROPOLITAN LIFE INSURANCE COMPANY | $29K | $4K | $33K | 8.74% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 1390 WILLOW PASS RD STE 800 CONCORD, CA 94520 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $13K | — | $13K | 4.94% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | 801 SOUTH FIGUEROA ST STE 800 LOS ANGELES, CA 90017 | BLUE CROSS OF CALIFORNIA | $1K | — | $1K | 0.73% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE | PO BOX 101162 PASADENA, CA 91189 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $381 | $5K | 10.65% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | PO BOX 101162 PASADENA, CA 91189 | VISION SERVICE PLAN | $2K | — | $2K | 3.85% |
| BEVER, PAUL, EDWARD3 | 334 STATE STREET, SUITE 205 LOS ALTOS, CA 94022 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 8.54% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | PO BOX 5668 CONCORD, CA 94520 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 3.71% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | PO BOX 101162 PASADENA, CA 91189 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $872 | $24 | $896 | 1.96% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | PO BOX 101162 PASADENA, CA 91189 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $378 | $3K | 10.59% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | ONE BUSH ST 9TH FLOOR SAN FRANCISCO, CA 94104 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $938 | — | $938 | 5.19% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 1390 WILLOW PASS RD STE 800 CONCORD, CA 94520 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $107 | — | $107 | 0.59% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE | PO BOX 101162 PASADENA, CA 91189 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $181 | $2K | 11.49% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | PO BOX 5668 CONCORD, CA 94520 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $921 | — | $921 | 8.92% |
| ENROLLEASE3 Filed as: ENROLLEASE LLC | EASECENTRAL 1980 FESTIVAL PLAZA DR STE 330 LAS VEGAS, NV 89135 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $491 | — | $491 | 4.75% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVC WEST | PO BOX 101162 PASADENA, CA 91189 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $368 | $47 | $415 | 4.02% |
| BEVER, PAUL, EDWARD3 | 334 STATE STREET, SUITE 205 LOS ALTOS, CA 94022 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | -$841 | — | -$841 | -8.14% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | PO BOX 101162 PASADENA, CA 91189 | VISION SERVICE PLAN | $333 | — | $333 | 10.07% |
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 | 564 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 7 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 574 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 340 | $5.4M |
| Dental(2 contracts) | METROPOLITAN LIFE INSURANCE COMPANY | 705 | $400K |
| Vision(2 contracts) | VISION SERVICE PLAN | 366 | $50K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 569 | $61K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 22 | $10K |
| Prescription drug(5 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 340 | $5.4M |
| Other(3 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 569 | $106K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 705 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.