| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 | PO BOX 28852 NEW YORK, NY 10087 | KAISER FOUNDATION HEALTH PLAN INC | $106K | — | $106K | 0.35% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3631 S HARBOR BLVD STE 200 SANTA ANA, CA 92704 | KAISER FOUNDATION HEALTH PLAN INC | $100K | — | $100K | 0.33% |
| USI INSURANCE SERVICES LLC3 | 21250 HAWTHORNE BLVD 6TH FLOOR TORRANCE, CA 90503 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $189K | $98K | $288K | 4.38% |
| TCS INSURANCE AGENCY INC3 | 101 LARKSPUR LANDING C STE 116 LARKSPUR, CA 94939 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $63K | $42K | $105K | 1.61% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, | LLC DBA L.B.L. INSURANCE 3130 S HARBOR BLVD, STE 140 SANTA ANA, CA 92704 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $175 | — | $175 | 2.05% |
| HASTINGS, BONNIE, J3 | 14931 CRYSTAL CIRCLE IRVINE, CA 92604 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $2 | $2 | 0.02% |
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 | 5,939 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 53 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 5,992 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 5,380 | $46.6M |
| Dental | AETNA LIFE INSURANCE CO. | 2,945 | $600K |
| Vision | VISION SERVICE PLAN | 5,129 | $988K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 20,345 | $6.6M |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 20,345 | $6.6M |
| Long-term disability(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 20,345 | $6.6M |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 20,345 | $6.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 20,345 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.