| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SERVICES OF CA | 18101 VON KARMEN AVE., SUITE 600 IRVINE, CA 92612 | CALIFORNIA PHYSICIANS' SERVICE (BLUE SHIELD OF CALIFORNIA) | $70 | $84K | $84K | 2.65% |
| AON CONSULTING INC3 Filed as: AON CONSULTING - KANSAS CITY | 29840 NETWORK PLACE CHICAGO, IL 60673 | CALIFORNIA PHYSICIANS' SERVICE (BLUE SHIELD OF CALIFORNIA) | $11K | $56K | $67K | 2.12% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE | 801 S. FIGUEROA STREET SUITE 800 LOS ANGELES, CA 900172591 | KAISER FOUNDATION HEALTH PLAN INC. | $12K | — | $12K | 2.37% |
| AON CONSULTING INC3 | 29840 NETWORK PLACE CHICAGO, IL 60673 | KAISER FOUNDATION HEALTH PLAN INC. | $8K | — | $8K | 1.56% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE | 801 S. FIGUEROA STREET SUITE 800 LOS ANGELES, CA 900172591 | KAISER FOUNDATION HEALTH PLAN INC. | $5K | — | $5K | 2.32% |
| AON CONSULTING INC3 | 29840 NETWORK PLACE CHICAGO, IL 60673 | KAISER FOUNDATION HEALTH PLAN INC. | $3K | — | $3K | 1.66% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE | 801 S. FIGUEROA STREET SUITE 800 LOS ANGELES, CA 900172591 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $2K | — | $2K | 3.33% |
| AON CONSULTING INC3 Filed as: AON CONSULTING INC. (SAN FRANCISCO) | 199 FREMONT STREET 14TH FLOOR SAN FRANCISCO, CA 94105 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $214 | — | $214 | 0.33% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE | 4250 EXECUTIVE SQUARE, SUITE 900 LA JOLLA, CA 92037 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 7.81% |
| AON CONSULTING INC3 | 707 WILSHIRE BLVD., SUITE 2600 LOS ANGELES, CA 900173533 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 5.19% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE | 4250 EXECUTIVE SQUARE, SUITE 900 LA JOLLA, CA 92037 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 5.74% |
| AON CONSULTING INC3 | 707 WILSHIRE BLVD., SUITE 2600 LOS ANGELES, CA 900173533 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 4.26% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE | 4250 EXECUTIVE SQUARE, SUITE 900 LA JOLLA, CA 92037 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $412 | — | $412 | 5.99% |
| AON CONSULTING INC3 | 707 WILSHIRE BLVD., SUITE 2600 LOS ANGELES, CA 900173533 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $277 | — | $277 | 4.02% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE | 4250 EXECUTIVE SQUARE, SUITE 900 LA JOLLA, CA 92037 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $264 | — | $264 | 6.47% |
| AON CONSULTING INC3 | 707 WILSHIRE BLVD., SUITE 2600 LOS ANGELES, CA 900173533 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $144 | — | $144 | 3.53% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE | 4250 EXECUTIVE SQUARE, SUITE 900 LA JOLLA, CA 92037 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $101 | — | $101 | 5.86% |
| AON CONSULTING INC3 | 707 WILSHIRE BLVD., SUITE 2600 LOS ANGELES, CA 900173533 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $72 | — | $72 | 4.17% |
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 | 374 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 377 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | CALIFORNIA PHYSICIANS' SERVICE (BLUE SHIELD OF CALIFORNIA) | 515 | $4.0M |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 170 | $28K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 384 | $48K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 15 | $4K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 7 | $2K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE (BLUE SHIELD OF CALIFORNIA) | 515 | $3.2M |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 384 | $48K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 515 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.