| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WELLS FARGO INSURANCE SERVICES3 | PO BOX 3900 SAN FRANCISCO, CA 94139 | AETNA LIFE INSURANCE COMPANY | $130K | $48K | $179K | 1.37% |
| WELLS FARGO INSURANCE SERVICES3 | 21250 HAWTHORNE BOULEVARD SUITE 600 TORRANCE, CA 90503 | FALLON HEALTH | $108K | — | $108K | 1.30% |
| WELLS FARGO INSURANCE SERVICES3 | PO BOX 3900 SAN FRANCISCO, CA 94139 | AETNA HEALTH, INC. | $44K | — | $44K | 0.99% |
| WELLS FARGO INSURANCE SERVICES3 | 600 HIGHWAY 169 SOUTH SAINT LOUIS PARK, MN 55426 | KAISER FOUNDATION HEALTH PLAN INC | $33K | — | $33K | 2.13% |
| WELLS FARGO INSURANCE SERVICES3 | 21250 HAWTHORNE BOULEVARD SUITE 600 TORRANCE, CA 90503 | HARTFORD LIFE AND ACCIDENT | $174K | — | $174K | 12.19% |
| WELLS FARGO INSURANCE SERVICES3 | 959 SKYWAY ROAD, 2ND FLOOR SAN CARLOS, CA 94070 | UNUM LIFE INSURANCE COMPANY | $51K | $3K | $53K | 15.73% |
| WELLS FARGO INSURANCE SERVICES3 | 21250 HAWTHORNE BOULEVARD SUITE 600 TORRANCE, CA 90503 | VISION SERVICE PLAN | $5K | — | $5K | 2.00% |
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 | 2,188 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,188 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 5 carriers) | AETNA LIFE INSURANCE COMPANY | 2,121 | $27.3M |
| Dental | HAWAII MEDICAL SERVICE ASSOCIATION | 2 | $17K |
| Vision | VISION SERVICE PLAN | 1,968 | $264K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 2,188 | $1.4M |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 2,188 | $1.4M |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 2,188 | $1.4M |
| Prescription drug(5 contracts, 5 carriers) | AETNA LIFE INSURANCE COMPANY | 2,121 | $27.3M |
| Other(4 contracts, 4 carriers) | HARTFORD LIFE AND ACCIDENT | 2,188 | $1.8M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,188 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.