| 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 | $361K | — | $361K | 0.50% |
| BLUE CHIP BENEFITS3 Filed as: BLUE CHIP BENEFITS, LLC | 4551 W 107TH ST STE 310 OVERLAND PARK, KS 662074037 | RELIASTAR LIFE INSURANCE COMPANY | — | $164K | $164K | 4.00% |
| CALLISTER, RICHARD C3 | 515 S FLOWER ST, FL 18 LOS ANGELES, CA 900712201 | RELIASTAR LIFE INSURANCE COMPANY | $103K | — | $103K | 2.50% |
| SHETH, SAMIR H3 | 1000 WILSHIRE BLVD STE 250 LOS ANGELES, CA 900172459 | RELIASTAR LIFE INSURANCE COMPANY | $103K | — | $103K | 2.50% |
| BLUE CHIP BENEFITS3 | 4551 W. 107TH STREET SUITE 310 OVERLAND PARK, KS 66207 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $174K | $12K | $186K | 5.34% |
| SHETH, SAMIR H3 Filed as: SHETH, SAMIR | 1000 WILSHIRE BLVD SUITE 1830 LOS ANGELES, CA 90017 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $87K | — | $87K | 2.50% |
| CALLISTER, RICHARD C3 | 1000 WILSHIRE BLVD SUITE 1830 LOS ANGELES, CA 90017 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $87K | — | $87K | 2.50% |
| BLUE CHIP BENEFITS3 Filed as: BLUE CHIP BENEFITS, LLC | 4551 W 107TH ST, STE 310 OVERLAND PARK, KS 662074037 | RELIASTAR LIFE INSURANCE COMPANY | — | $28K | $28K | 4.00% |
| CALLISTER, RICHARD C3 | 515 S FLOWER ST, FL 18 LOS ANGELES, CA 900712201 | RELIASTAR LIFE INSURANCE COMPANY | $18K | — | $18K | 2.50% |
| SHETH, SAMIR H3 | 1000 WILSHIRE BLVD STE 250 LOS ANGELES, CA 900172459 | RELIASTAR LIFE INSURANCE COMPANY | $18K | — | $18K | 2.50% |
| WILLIS TOWERS WATSON US LLC4 | PO BOX 28852 NEW YORK, NY 10087 | DELTA DENTAL OF CALIFORNIA | $22K | — | $22K | 3.13% |
| VERITYPOINT LLC3 | 515 S. FLOWER ST., 18TH FLOOR LOS ANGELES, CA 90071 | METLIFE LEGAL PLANS | $48K | — | $48K | 10.93% |
| BLUE CHIP BENEFITS3 | 4551 W. 107TH STREET SUITE 310 OVERLAND PARK, KS 66207 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $952 | $602 | $2K | 8.16% |
| CALLISTER, RICHARD C3 | 1000 WILSHIRE BLVD SUITE 1830 LOS ANGELES, CA 90017 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $476 | — | $476 | 2.50% |
| SHETH, SAMIR H3 Filed as: SHETH, SAMIR | 1000 WILSHIRE BLVD SUITE 1830 LOS ANGELES, CA 90017 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $476 | — | $476 | 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 | 15,464 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1,877 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 138 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 17,479 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | ANTHEM BLUE CROSS | 6,567 | $119.4M |
| Dental | DELTA DENTAL OF CALIFORNIA | 5,011 | $692K |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 21,538 | $2.0M |
| Life insurance | RELIASTAR LIFE INSURANCE COMPANY | 25,410 | $4.1M |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 572 | $19K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 17,788 | $3.5M |
| Stop-loss / reinsurancereinsurance | BERKLEY LIFE AND HEALTH INSURANCE CO. | 17,479 | $2.3M |
| Other(2 contracts, 2 carriers) | RELIASTAR LIFE INSURANCE COMPANY | 20,276 | $1.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 25,410 | — |
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.