| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC | PO BOX 28852 NEW YORK, NY 100878852 | KAISER FOUNDATION HEALTH PLAN INC. | $70K | — | $70K | 0.59% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC | LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 100878852 | AETNA LIFE INSURANCE CO. | $70K | $150K | $220K | 8.18% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC | LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $25K | — | $25K | 1.49% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC | PO BOX 28852 NEW YORK, NY 100878852 | VISION SERVICE PLAN | $16K | — | $16K | 3.00% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC | LOCKBOX 28852 P.O. BOX 28852 NEW YORK, NY 10087 | DELTA DENTAL OF CALIFORNIA | $2K | — | $2K | 1.50% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC | PO BOX 28852 LOCKBOX 28852 NEW YORK, NY 10087 | UNITEDHEALTHCARE INSURANCE COMPANY | $10K | — | $10K | 13.69% |
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 | 4,495 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 47 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 98 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 4,640 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 2,612 | $13.0M |
| Dental | DELTA DENTAL OF CALIFORNIA | 1,192 | $159K |
| Vision(2 contracts, 2 carriers) | VISION SERVICE PLAN | 2,949 | $614K |
| Life insurance | AETNA LIFE INSURANCE CO. | 6,189 | $2.7M |
| Short-term disability | AETNA LIFE INSURANCE CO. | 6,189 | $2.7M |
| Long-term disability | AETNA LIFE INSURANCE CO. | 6,189 | $2.7M |
| Prescription drug(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC. | 2,612 | $13.0M |
| Stop-loss / reinsurancereinsurance | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 4,475 | $1.7M |
| Other(3 contracts, 3 carriers) | AETNA LIFE INSURANCE CO. | 6,189 | $2.7M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 6,189 | — |
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.