| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | DEPT 133667 PO BOX 3900 SAN FRANCISCO, CA 94139 | AETNA LIFE INSURANCE CO | $125K | $55K | $180K | 1.40% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | 21250 HAWTHORNE BLVD SUITE 600 TORRANCE, CA 90503 | FALLON HEALTH | $111K | — | $111K | 1.29% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | DEPT 133667 PO BOX 3900 SAN FRANCISCO, CA 94139 | AETNA HEALTH INC | $14K | — | $14K | 0.82% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | 600 HIGHWAY 169 S 12TH FL SAINT LOUIS PARK, MN 55426 | KAISER FOUNDATION HEALTH PLAN INC | $28K | — | $28K | 1.83% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | 21250 HAWTHORNE BLVD STE 600 TORRANCE, CA 90503 | HARTFORD LIFE AND ACCIDENT | $74K | — | $74K | 5.00% |
| WELLS FARGO INSURANCE SERVICES3 | 10 SOUTH WACKER DRIVE FLOOR 17 CHICAGO, IL 60606 | HARTFORD LIFE AND ACCIDENT | — | $22K | $22K | 1.48% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | DEPT 133667 PO BOX 3900 SAN FRANCISCO, CA 94139 | AETNA LIFE INSURANCE CO | $6K | — | $6K | 0.91% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | 959 SKYWAY RD 2ND FL SAN CARLOS, CA 94070 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $52K | — | $52K | 14.38% |
| WELLS FARGO INSURANCE SERVICES3 | 45 FREMONT STE 800 SAN FRANCISCO, CA 94105 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $15 | $15 | 0.00% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | PO BOX 39000 SAN FRANCISCO, CA 94139 | VISION SERVICE PLAN | $5K | — | $5K | 2.00% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | DEPT 133667 PO BOX 3900 SAN FRANCISCO, CA 94139 | AETNA LIFE INSURANCE CO | $650 | — | $650 | 0.91% |
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 | 2,152 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 15 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 2,167 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(6 contracts, 4 carriers) | AETNA LIFE INSURANCE CO | 1,761 | $23.8M |
| Dental | HAWAII MEDICAL SERVICE ASSOCIATION | 2 | $16K |
| Vision | VISION SERVICE PLAN | 1,970 | $265K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 2,152 | $1.5M |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 2,152 | $1.5M |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 2,152 | $1.5M |
| Prescription drug(2 contracts, 2 carriers) | FALLON HEALTH | 1,533 | $10.1M |
| Other(5 contracts, 5 carriers) | HARTFORD LIFE AND ACCIDENT | 2,197 | $1.9M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,197 | — |
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.