| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS OF CA INC. | 2010 MAIN STREET, SUITE 1050 IRVINE, CA 92614 | KAISER FOUNDATION HEALTH PLAN INC. | $96K | — | $96K | 4.94% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS OF CA INC. | 2010 MAIN STREET, SUITE 1050 IRVINE, CA 92614 | CALIFORNIA PHYSICIANS' SERVICE | $805 | $71K | $71K | 5.27% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS OF CA INC. | 2010 MAIN STREET, SUITE 1050 IRVINE, CA 92614 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $19K | — | $19K | 9.92% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS OF CA INC. | 2010 MAIN STREET, SUITE 1050 IRVINE, CA 92614 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $10K | $809 | $10K | 10.84% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS OF CA INC. | 2010 MAIN STREET, SUITE 1050 IRVINE, CA 92614 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | $504 | $6K | 10.93% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS OF CA INC. | 2010 MAIN STREET, SUITE 1050 IRVINE, CA 92614 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | $519 | $7K | 26.36% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS OF CA INC. | 2010 MAIN STREET, SUITE 1050 IRVINE, CA 92614 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $354 | $4K | 25.15% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | PO BOX 6030 PASADENA, CA 91102 | METROPOLITAN LIFE INSURANCE COMPANY | $8 | — | $8 | 0.05% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS OF CA INC. | 2010 MAIN STREET, SUITE 1050 IRVINE, CA 92612 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 9.97% |
| WANGLIN, RONALD, CHASE3 | PO BOX 6030 PASADENA, CA 91102 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $509 | — | $509 | 3.50% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS OF CA INC. | 2010 MAIN STREET, SUITE 1050 IRVINE, CA 92614 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | $105 | $1K | 10.95% |
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 | 264 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 264 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 254 | $3.3M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 350 | $190K |
| Vision | CALIFORNIA PHYSICIANS' SERVICE | 117 | $1.4M |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 357 | $96K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 357 | $54K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 254 | $3.3M |
| Other(4 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 357 | $69K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 357 | — |
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.