| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA, INC | 18101 VON KARMAN AVE STE 600 IRVINE, CA 92612 | CALIFORNIA PHYSICIANS' SERVICE | $128K | $4K | $132K | 4.11% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA INC | PO BOX 101162 PASADENA, CA 91189 | VISION SERVICE PLAN | $1K | — | $1K | 4.98% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA INC | 4250 EXECUTIVE SQ SUITE 900 LA JOLLA, CA 92037 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 13.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA INC | 801 S FIGUEROA ST, STE 800 LOS ANGELES, CA 90017 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $1K | — | $1K | 5.75% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA | 444 MARKET ST STE 1600 SAN FRANCISCO, CA 94111 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $578 | — | $578 | 3.28% |
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 | 284 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 12 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 297 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA PHYSICIANS' SERVICE | 245 | $3.2M |
| Vision | VISION SERVICE PLAN | 147 | $26K |
| Life insurance(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 285 | $42K |
| Prescription drug | CALIFORNIA PHYSICIANS' SERVICE | 245 | $3.2M |
| Other | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 285 | $18K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 285 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.