| 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 | $392K | — | $392K | 0.75% |
| BLUE CHIP BENEFITS3 Filed as: BLUE CHIP BENEFITS, LLC | 410 ARCHIBALD ST KANSAS CITY, MO 641113288 | RELIASTAR LIFE INSURANCE COMPANY | — | $138K | $138K | 4.00% |
| SHETH, SAMIR H3 | 1000 WILSHIRE BLVD STE 250 LOS ANGELES, CA 900172459 | RELIASTAR LIFE INSURANCE COMPANY | — | $86K | $86K | 2.50% |
| CALLISTER, RICHARD C3 | 1000 WILSHIRE BLVD STE 1830 LOS ANGELES, CA 900175688 | RELIASTAR LIFE INSURANCE COMPANY | — | $86K | $86K | 2.50% |
| BLUE CHIP BENEFITS3 | 4551 W. 107TH STREET SUITE 310 OVERLAND PARK, KS 66207 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $158K | $6K | $164K | 5.19% |
| SHETH, SAMIR H3 Filed as: SHETH, SAMIR | 1000 WILSHIRE BLVD SUITE 1830 LOS ANGELES, CA 90017 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $79K | — | $79K | 2.50% |
| CALLISTER, RICHARD C3 | 1000 WILSHIRE BLVD SUITE 1830 LOS ANGELES, CA 90017 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $79K | — | $79K | 2.50% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE | PO BOX 28852 NEW YORK, NY 10087 | DELTA DENTAL OF CALIFORNIA | $21K | — | $21K | 3.00% |
| BLUE CHIP BENEFITS3 Filed as: BLUE CHIP BENEFITS, LLC | 410 ARCHIBALD ST KANSAS CITY, MO 641113288 | RELIASTAR LIFE INSURANCE COMPANY | — | $23K | $23K | 4.00% |
| SHETH, SAMIR H3 | 1000 WILSHIRE BLVD STE 250 LOS ANGELES, CA 900172459 | RELIASTAR LIFE INSURANCE COMPANY | — | $14K | $14K | 2.50% |
| CALLISTER, RICHARD C3 | 1000 WILSHIRE BLVD STE 1830 LOS ANGELES, CA 900175688 | RELIASTAR LIFE INSURANCE COMPANY | — | $14K | $14K | 2.50% |
| VERITYPOINT LLC3 | 1000 WILSHIRE BLVD, SUITE 1830 LOS ANGELES, CA 90017 | HYATT LEGAL PLANS | $39K | — | $39K | 10.00% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE | PO BOX 28852 NEW YORK, NY 10087 | HYATT LEGAL PLANS | — | $92 | $92 | 0.02% |
| BLUE CHIP BENEFITS3 | 4551 W. 107TH STREET SUITE 310 OVERLAND PARK, KS 66207 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $892 | $564 | $1K | 8.17% |
| CALLISTER, RICHARD C3 | 1000 WILSHIRE BLVD SUITE 1830 LOS ANGELES, CA 90017 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $446 | — | $446 | 2.50% |
| SHETH, SAMIR H3 Filed as: SHETH, SAMIR | 1000 WILSHIRE BLVD SUITE 1830 LOS ANGELES, CA 90017 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $446 | — | $446 | 2.50% |
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 | 13,510 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1,582 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 15,092 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | ANTHEM BLUE CROSS | 6,651 | $81.1M |
| Dental | DELTA DENTAL OF CALIFORNIA | 4,839 | $695K |
| Vision | VISION SERVICE PLAN | 9,560 | $2.0M |
| Life insurance | RELIASTAR LIFE INSURANCE COMPANY | 21,708 | $3.4M |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 469 | $18K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 16,085 | $3.2M |
| Other(2 contracts, 2 carriers) | RELIASTAR LIFE INSURANCE COMPANY | 17,851 | $967K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 21,708 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.