| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC. | PO BOX 28852P NEW YORK, NY 100878852 | KAISER FOUNDATION HEALTH PLAN INC | $59K | — | $59K | 1.90% |
| UNIFIED GROCERS INSURANCE SERVICES3 Filed as: UNIFIED GROCERS INS. SERVICES INC. | 874 SOUTH VILLAGE OAKS DRIVE COVINA, CA 917243614 | KAISER FOUNDATION HEALTH PLAN INC | $35K | — | $35K | 1.11% |
| INSURANCE OFFICE OF AMERICA3 Filed as: INSURANCE OFFICE OF AMERICA, INC. | 1855 W STATE ROAD 434 LONGWOOD, FL 327505069 | KAISER FOUNDATION HEALTH PLAN INC | $8K | — | $8K | 0.27% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC. | PO BOX 28852P NEW YORK, NY 100878852 | KAISER FOUNDATION HEALTH PLAN INC | $14K | — | $14K | 1.96% |
| UNIFIED GROCERS INSURANCE SERVICES3 Filed as: UNIFIED GROCERS INS. SERVICES, INC. | 874 SOUTH VILLAGE OAKS DRIVE COVINA, CA 917243614 | KAISER FOUNDATION HEALTH PLAN INC | $8K | — | $8K | 1.06% |
| INSURANCE OFFICE OF AMERICA3 Filed as: INSURANCE OFFICE OF AMERICA, INC. | 1855 W STATE ROAD 434 LONGWOOD, FL 327505069 | KAISER FOUNDATION HEALTH PLAN INC | $2K | — | $2K | 0.26% |
| UNIFIED GROCERS INSURANCE3 | 874 S VILLAGE OAKS DR COVINA, CA 91724 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $25K | — | $25K | 5.02% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $24K | — | $24K | 4.96% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC - OH | 1001 LAKESIDE AVE CLEVELAND, OH 44114 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $5K | — | $5K | 1.24% |
| UNIFIED GROCERS INSURANCE SERVICES3 Filed as: UNIFIED GROCERS INS. SERVICES, INC. | 874 SOUTH VILLAGE OAKS DRIVE COVINA, CA 91724 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $4K | — | $4K | 0.89% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC. | 300 SOUTH GRAND AVE SUITE 2000 LOS ANGELES, CA 90071 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. | $2K | — | $2K | 1.24% |
| UNIFIED GROCERS INSURANCE SERVICES3 Filed as: UNIFIED GROCERS INS. SERVICES, INC | 874 SOUTH VILLAGE OAKS DR COVINA, CA 91724 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. | $1K | — | $1K | 0.81% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC | LOCBOX #28852 PO BOX 28852 NEW YORK, NY 100878852 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $7K | — | $7K | 5.44% |
| UNIFIED GROCERS INSURANCE SERVICES3 | 874 S VILLAGE OAKS DR COVINA, CA 91724 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $6K | — | $6K | 4.56% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC | LOCKBOX #28852 PO BOX 28852 NEW YORK, NY 100878852 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $7K | — | $7K | 5.46% |
| UNIFIED GROCERS INSURANCE SERVICES3 | 874 S VILLAGE OAKS DR COVINA, CA 91724 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $6K | — | $6K | 4.54% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC | LOCKBOX #28852 PO BOX 28852 NEW YORK, NY 10087 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $10K | — | $10K | 9.50% |
| UNIFIED GROCERS INSURANCE3 Filed as: UNIFIED GROCERS INSURANCE SVCS | 874 S VILLAGE OAKS DR COVINA, CA 91724 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | — | $6K | 5.88% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC. | 2010 MAIN STREET SUITE 1050 IRVINE, CA 92614 | NATIONAL UNION FIRE INSURANCE CO OF PITTSBURGH, PA | $5K | — | $5K | 15.00% |
| UNIFIED GROCERS INSURANCE SERVICES3 | PO BOX 4193 COVINA, CA 917230593 | SAFEGUARD HEALTH PLANS, INC,. A CALIFORNIA CORPORATION | $604 | — | $604 | 2.88% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC | PO BOX 28852 NEW YORK, NY 100878852 | SAFEGUARD HEALTH PLANS, INC,. A CALIFORNIA CORPORATION | $181 | $217 | $398 | 1.90% |
| UNIFIED GROCERS INSURANCE3 | 874 S VILLAGE OAKS DR COVINA, CA 91724 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $976 | — | $976 | 5.00% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $976 | — | $976 | 5.00% |
| UNIFIED GROCERS INSURANCE SERVICES3 Filed as: UNIFIED GROCERS INS. SERVICES, INC. | 874 S VILLAGE OAKS DRIVE COVINA, CA 91724 | NATIONAL UNION FIRE INSURANCE CO OF PITTSBURGH, PA | $2K | — | $2K | 15.00% |
| UNIFIED GROCERS INSURANCE3 Filed as: UNIFIED GROCERS INC SERVICES INC | 874 SOUTH VILLAGE OAKS DRIVE COVINA, CA 91724 | HARTFORD LIFE AND ACCIDENT | $1K | — | $1K | 15.00% |
| UNIFIED GROCERS INSURANCE SERVICES3 Filed as: UNIFIED GROCERS INS. SERVICES, INC. | PO BOX 30398 LOS ANGELES, CA 90030 | HARTFORD LIFE AND ACCIDENT | $481 | — | $481 | 15.01% |
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 | 1,070 | 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) | 1,086 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 569 | $4.4M |
| Dental | SAFEGUARD HEALTH PLANS, INC,. A CALIFORNIA CORPORATION | 145 | $21K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,070 | $491K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 1,068 | $137K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 1,067 | $125K |
| Prescription drug(5 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 569 | $4.4M |
| Stop-loss / reinsurancereinsurance | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 1,399 | $0 |
| Other(7 contracts, 4 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,070 | $682K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,399 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.