| 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 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $17K | — | $17K | 1.60% |
| ALLIANT INSURANCE SERVICES, INC.3 | 2121 N. CALIFORNIA BLVD, SUITE 1000 WALNUT CREEK, CA 94596 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $7K | — | $7K | 0.63% |
| ALLIANT INSURANCE SERVICES, INC.3 | 2121 N. CALIFORNIA BLVD, SUITE 1000 WALNUT CREEK, CA 94596 | HARTFORD LIFE AND ACCIDENT | — | $43 | $43 | 1.98% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON, HEALTH AND GROUP BFT | UNKNOWN REDWOOD CITY, CA 94065 | ANAHITA INSURANCE CORPORATION | $100 | — | $100 | 10.00% |
| HARTFORD LIFE3 | UNKNOWN REDWOOD CITY, CA 94065 | ANAHITA INSURANCE CORPORATION | $50 | — | $50 | 5.00% |
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 | 2,038 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 16 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,054 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 347 | $3.2M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 3,457 | $1.4M |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,038 | $1.1M |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,038 | $1.1M |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,038 | $1.1M |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 347 | $3.2M |
| Other(4 contracts, 4 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 4,983 | $1.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,983 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.