| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH ST STE 900 KANSAS CITY, MO 64112 | CALIFORNIA PHYSICIANS' SERVICE | $0 | $90K | $90K | 3.79% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SERVICES OF | CALIFORNIA, INC. 2010 MAIN ST., STE 1050 IRVINE, CA 92614 | CALIFORNIA PHYSICIANS' SERVICE | — | $10K | $10K | 0.40% |
| LOCKTON COMPANIES, LLC3 | 444 W 47TH ST STE 900 KANSAS CITY, MO 641121906 | KAISER FOUNDATION HEALTH PLAN INC | $47K | — | $47K | 3.32% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE | SERVICES WEST INC. 801 S FIGUEROA ST STE 800 LOS ANGELES, CA 900172591 | KAISER FOUNDATION HEALTH PLAN INC | $10K | — | $10K | 0.68% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSU | PO BOX 101162 PASADENA, CA 91189 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $672 | $672 | 1.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSU | PO BOX 101162 PASADENA, CA 91189 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $101 | $101 | 0.16% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSU | PO BOX 101162 PASADENA, CA 91189 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $101 | $101 | 0.96% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST INC | 233 S WACKER DR STE 2000 CHICAGO, IL 60606 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $381 | $0 | $381 | 3.65% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWER WATSON INS SVCS WEST | 525 MARKET STREET, SUITE 3400 SAN FRANCISCO, CA 94015 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | -$29 | $0 | -$29 | -0.28% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSU | PO BOX 101162 PASADENA, CA 91189 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $59 | $59 | 0.91% |
| REUBEN WARNER ASSOCIATES, INC.3 | 1655 RICHMOND AVENUE STATEN ISLAND, NY 10314 | FEDERAL INSURANCE COMPANY | $767 | — | $767 | 20.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWER WATSON | 18101 VON KARMAN AVENUE SUITE 600 IRVINE, CA 92612 | FEDERAL INSURANCE COMPANY | $575 | — | $575 | 14.99% |
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 | 299 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 304 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 221 | $3.8M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 61 | $10K |
| Vision | VISION SERVICE PLAN | 216 | $34K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 299 | $67K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 299 | $62K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 221 | $3.8M |
| Other(3 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 572 | $21K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 572 | — |
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.