| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 19000 MACARTHUR BLVD IRVINE, CA 92612 | AETNA LIFE INSURANCE CO. | $10K | — | $10K | 2.57% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 425 CALIFORNIA ST STE 2400 SAN FRANCISCO, CA 941042215 | KAISER FOUNDATION HEALTH PLAN INC | $13K | — | $13K | 3.67% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 350 S GRAND AVE STE 4500 LOS ANGELES, CA 90071 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $7K | — | $7K | 15.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON | INSURANCE SERVICES PO BOX 101162 PASADENA, CA 91189 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $751 | $751 | 1.55% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 350 S GRAND AVE STE 4500 LOS ANGELES, CA 90071 | LIFE INSURANCE COMPANY NORTH AMERICA | $3K | — | $3K | 15.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON | INSURANCE SERVICES PO BOX 101162 PASADENA, CA 91189 | LIFE INSURANCE COMPANY NORTH AMERICA | — | $320 | $320 | 1.44% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | PO BOX 102159 PASADENA, CA 911892189 | VISION SERVICE PLAN | $908 | — | $908 | 6.28% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 350 S GRAND AVE STE 4500 LOS ANGELES, CA 90071 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 15.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE SERV | PO BOX 101162 PASADENA, CA 91189 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $143 | $143 | 1.42% |
| VOLUNTARY BENEFIT ADVISORS3 Filed as: VOLUNTARY BENEFIT ADVISORS INC | 2400 MAIN ST STE 200 IRVINE, CA 92614 | TRANSAMERICA LIFE INSURANCE COMPANY | $382 | — | $382 | 4.14% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON | INSURANCE SERVICES 525 MARKET ST, SUITE 3400 SAN FRANCISCO, CA 94105 | TRANSAMERICA LIFE INSURANCE COMPANY | $164 | — | $164 | 1.78% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 350 S GRAND AVE STE 4500 LOS ANGELES, CA 90071 | LIFE INSURANCE COMPAY OF NORTH AMERICA | $1K | — | $1K | 15.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE SRVS | PO BOX 101162 PASADENA, CA 91189 | LIFE INSURANCE COMPAY OF NORTH AMERICA | — | $103 | $103 | 1.47% |
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 | 132 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 132 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA LIFE INSURANCE CO. | 228 | $763K |
| Dental | AETNA LIFE INSURANCE CO. | 228 | $400K |
| Vision | VISION SERVICE PLAN | 114 | $14K |
| Life insurance(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 136 | $58K |
| Short-term disability(2 contracts) | LIFE INSURANCE COMPANY NORTH AMERICA | 132 | $32K |
| Long-term disability | LIFE INSURANCE COMPANY NORTH AMERICA | 132 | $22K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 79 | $363K |
| Other(2 contracts, 2 carriers) | TRANSAMERICA LIFE INSURANCE COMPANY | 137 | $16K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 228 | — |
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.