| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC4 | PO BOX 28852 LOCKBOX 28852 NEW YORK, NY 100878852 | ANTHEM BLUE CROSS | $374K | — | $374K | 0.58% |
| BLUE CHIP BENEFITS3 Filed as: BLUE CHIP BENEFITS, LLC | 410 ARCHIBALD ST KANSAS CITY, MO 641113288 | RELIASTAR LIFE INSURANCE COMPANY | — | $148K | $148K | 4.00% |
| SHETH, SAMIR H3 | 1000 WILSHIRE BLVD STE 250 LOS ANGELES, CA 900172459 | RELIASTAR LIFE INSURANCE COMPANY | — | $92K | $92K | 2.50% |
| CALLISTER, RICHARD C3 | 1000 WILSHIRE BLVD STE 1830 LOS ANGELES, CA 900175688 | RELIASTAR LIFE INSURANCE COMPANY | — | $92K | $92K | 2.50% |
| BLUE CHIP BENEFITS3 | 4551 W. 107TH STREET SUITE 310 OVERLAND PARK, KS 66207 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $181K | — | $181K | 5.00% |
| SHETH, SAMIR H3 Filed as: SHETH, SAMIR | 1000 WILSHIRE BLVD SUITE 1830 LOS ANGELES, CA 90017 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $90K | — | $90K | 2.50% |
| CALLISTER, RICHARD C3 | 1000 WILSHIRE BLVD SUITE 1830 LOS ANGELES, CA 90017 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $90K | — | $90K | 2.50% |
| WILLIS TOWERS WATSON US LLC4 | 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 | — | $24K | $24K | 4.00% |
| SHETH, SAMIR H3 | 1000 WILSHIRE BLVD STE 250 LOS ANGELES, CA 900172459 | RELIASTAR LIFE INSURANCE COMPANY | — | $15K | $15K | 2.50% |
| CALLISTER, RICHARD C3 | 1000 WILSHIRE BLVD STE 1830 LOS ANGELES, CA 900175688 | RELIASTAR LIFE INSURANCE COMPANY | — | $15K | $15K | 2.50% |
| VERITYPOINT LLC3 | 1000 WILSHIRE BLVD, SUITE 1830 LOS ANGELES, CA 90017 | METLIFE LEGAL PLANS | $41K | — | $41K | 12.01% |
| WILLIS TOWERS WATSON US LLC4 | PO BOX 28852 NEW YORK, NY 10087 | METLIFE LEGAL PLANS | — | $61 | $61 | 0.02% |
| BLUE CHIP BENEFITS3 | 4551 W. 107TH STREET SUITE 310 OVERLAND PARK, KS 66207 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $984 | — | $984 | 5.00% |
| CALLISTER, RICHARD C3 | 1000 WILSHIRE BLVD SUITE 1830 LOS ANGELES, CA 90017 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $492 | — | $492 | 2.50% |
| SHETH, SAMIR H3 Filed as: SHETH, SAMIR | 1000 WILSHIRE BLVD SUITE 1830 LOS ANGELES, CA 90017 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $492 | — | $492 | 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 | 14,155 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1,693 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 15,848 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | ANTHEM BLUE CROSS | 6,497 | $100.7M |
| Dental | DELTA DENTAL OF CALIFORNIA | 4,900 | $702K |
| Vision | VISION SERVICE PLAN | 10,020 | $2.1M |
| Life insurance | RELIASTAR LIFE INSURANCE COMPANY | 22,887 | $3.7M |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 488 | $20K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 16,072 | $3.6M |
| Other(2 contracts, 2 carriers) | RELIASTAR LIFE INSURANCE COMPANY | 18,508 | $949K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 22,887 | — |
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."
No prospect flags tripped on this filing.