| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC. | PO BOX 28852 LOCKBOX 28852 NEW YORK, NY 10087 | ANTHEM BLUE CROSS | $371K | — | $371K | 0.54% |
| FRED MAXWELL - ACIUS GROUP3 Filed as: FRED THOMAS MAXWELL | 2591 DALLAS PARKWAY, SUITE 203 FRISCO, TX 75034 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $170K | — | $170K | 5.66% |
| FRED MAXWELL - ACIUS GROUP3 Filed as: FRED T MAXWELL II | 2591 DALLAS PARKWAY STE 203 FRISCO, TX 75034 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $204K | $10K | $214K | 7.47% |
| FRED MAXWELL - ACIUS GROUP3 Filed as: FRED T MAXWELL II | 2591 DALLAS PKWY STE 203 FRISCO, TX 75034 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $28K | $4K | $32K | 3.15% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE | PO BOX 8500 PHILADELPHIA, PA 19178 | DELTA DENTAL OF CALIFORNIA | $24K | — | $24K | 3.00% |
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 | 11,710 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 67 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 162 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 11,939 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | ANTHEM BLUE CROSS | 8,471 | $75.8M |
| Dental | DELTA DENTAL OF CALIFORNIA | 4,865 | $815K |
| Vision | VISION SERVICE PLAN | 8,146 | $1.6M |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 13,630 | $3.9M |
| Short-term disability | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 12,674 | $3.0M |
| Long-term disability | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 12,674 | $3.0M |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 13,630 | $3.9M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 13,630 | — |
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.