| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS OF CA INC. | 18101 VON KARMAN AVENUE, SUITE 600 IRVINE, CA 92612 | KAISER FOUNDATION HEALTH PLAN INC. | $112K | — | $112K | 5.38% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS OF CA INC. | 18101 VON KARMAN AVENUE, SUITE 600 IRVINE, CA 92612 | CALIFORNIA PHYSICIANS' SERVICE | $805 | $72K | $73K | 5.43% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS OF CA INC. | 18101 VON KARMAN AVENUE, SUITE 600 IRVINE, CA 92612 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $18K | $6 | $18K | 9.93% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS OF CA INC. | 18101 VON KARMAN AVENUE, SUITE 600 IRVINE, CA 92612 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $8K | $735 | $9K | 10.89% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS OF CA INC. | 18101 VON KARMAN AVENUE, SUITE 600 IRVINE, CA 92612 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | $483 | $6K | 10.86% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS OF CA INC. | 18101 VON KARMAN AVENUE, SUITE 600 IRVINE, CA 92612 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | $515 | $6K | 18.27% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | PO BOX 6030 PASADENA, CA 91102 | METROPOLITAN LIFE INSURANCE COMPANY | $245 | — | $245 | 0.69% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS OF CA INC. | 18101 VON KARMAN AVENUE, SUITE 600 IRVINE, CA 92612 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $324 | $4K | 20.39% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | PO BOX 6030 PASADENA, CA 91102 | METROPOLITAN LIFE INSURANCE COMPANY | $18 | — | $18 | 0.10% |
| WANGLIN, RONALD, CHASE3 | PO BOX 6030 PASADENA, CA 91102 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $648 | — | $648 | 4.63% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS OF CA INC. | 18101 VON KARMAN AVENUE, SUITE 600 IRVINE, CA 92612 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $564 | — | $564 | 4.03% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS OF CA INC. | 18101 VON KARMAN AVENUE, SUITE 600 IRVINE, CA 92612 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | $104 | $1K | 10.88% |
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 | 453 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 460 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 308 | $3.4M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 406 | $181K |
| Vision | CALIFORNIA PHYSICIANS' SERVICE | 137 | $1.3M |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 453 | $83K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 453 | $56K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 308 | $3.4M |
| Other(4 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 453 | $79K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 453 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.