| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC | PO BOX 28852P NEW YORK, NY 100878852 | KAISER FOUNDATION HEALTH PLAN INC. | $13K | — | $13K | 0.46% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON PENNSYLVANIA INC | LOCKBOX #9102 PO BOX 8500 PHILADELPHIA, PA 191780001 | KAISER FOUNDATION HEALTH PLAN INC. | $7K | — | $7K | 0.24% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE IN | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $71K | — | $71K | 5.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC | PO BOX 28852P NEW YORK, NY 100878852 | KAISER FOUNDATION HEALTH PLAN INC. | $6K | — | $6K | 0.44% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON PENNSYLVANIA INC | LOCKBOX #9102 PO BOX 8500 PHILADELPHIA, PA 191780001 | KAISER FOUNDATION HEALTH PLAN INC. | $3K | — | $3K | 0.24% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE IN | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $47K | — | $47K | 5.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE IN | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $9K | — | $9K | 5.00% |
| AMERICAN BENEFITS & COMP SYSTEMS3 Filed as: AMERICAN BENEFITS & COMP SYS, INC. | 99 PARK AVENUE 25TH FLOOR NEW YORK, NY 10016 | HYATT LEGAL PLANS | $11K | $2K | $13K | 11.86% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE IN | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | CIGNA LIFE INSURANCE CO. OF NEW YORK | $988 | — | $988 | 5.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC | LOCKBOX 28852 NEW YORK, NY 10087 | HARTFORD LIFE AND ACCIDENT | — | $185 | $185 | 3.25% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC | COMMISSION LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $36 | — | $36 | 5.03% |
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 | 4,057 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 188 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 4,245 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 690 | $4.5M |
| Dental(2 contracts, 2 carriers) | AETNA LIFE INSURANCE CO. | 1,365 | $258K |
| Vision | VISION SERVICE PLAN | 3,348 | $545K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 7,122 | $1.4M |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 4,895 | $934K |
| Other(6 contracts, 5 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 4,895 | $338K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 7,122 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.