| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC. | COM LOCKBOX 28852 P.O. BOX 28852 NEW YORK, NY 10087 | MINNESOTA LIFE INSURANCE COMPANY | $335K | — | $335K | 5.60% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC. | COM LOCKBOX 28852 P.O. BOX 28852 NEW YORK, NY 10087 | MINNESOTA LIFE INSURANCE COMPANY | — | $136K | $136K | 2.28% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC. | COMMISSION LOCKBOX 28852 P.O. BOX 28852 NEW YORK, NY 10087 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $122K | $72K | $193K | 5.95% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC. | COM LOCKBOX 28852 P.O. BOX 28852 NEW YORK, NY 10087 | MINNESOTA LIFE INSURANCE COMPANY | — | $40K | $40K | 2.28% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC. | COM LOCKBOX 28852 P.O. BOX 28852 NEW YORK, NY 10087 | MINNESOTA LIFE INSURANCE COMPANY | $11K | — | $11K | 0.65% |
| WILLIS TOWERS WATSON US LLC Filed as: TOWERS WATSON DELAWARE INC. | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $83K | — | $83K | 8.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC. | COMMISSION LOCKBOX 28852 P.O. BOX 28852 NEW YORK, NY 10087 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | — | $2K | $2K | 0.77% |
| WILLIS TOWERS WATSON US LLC Filed as: TOWERS WATSON DELAWARE INC. | COMMISSION LOCKBOX 28852 P.O. BOX 28852 NEW YORK, NY 10087 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | — | $6K | $6K | 2.35% |
| ALLIANT INSURANCE SERVICES, INC. Filed as: ALLIANT INSURANCE SERVICE | 701 B STREET 6TH FLOOR SAN DIEGO, CA 92101 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $14K | $1K | $15K | 7.62% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON DELAWARE INC. | COMMISSION LOCKBOX #28852 P.O. BOX 28852 NEW YORK, NY 10087 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | — | $1K | $1K | 0.67% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES INC. EIN 41-1289245 CLAIMS PROCESSOR/MEDICAL | Claims processing; Other services Service code 12 | P.O. BOX 1459 MN009-W235 MINNEAPOLIS, MN 55440 | $7.7M |
| ANTHERM BLUE CROSS EIN 95-3760980 CONTRACT ADMINISTRATOR | Claims processing Service code 12 | P.O. BOX 26016 RICHMOND, VA 23260 | $534K |
| DELTA DENTAL OF CALIFORNIA EIN 94-1461312 CLAIMS PROCESSOR/DENTAL | Claims processing; Other services Service code 12 | 17871 PARK PLAZA DRIVE SUITE 200 CERRITOS, CA 90703 | $518K |
| CONNECTYOURCARE HSA/FSA/DCRA ADMINISTRATO | Claims processing Service code 12 | 307 INTERNATIONAL CIRCLE SUITE 200 HUNT VALLEY, MD 21030 | $263K |
| VISION SERVICE PLAN EIN 94-1632821 CLAIMS PROCESSOR - VISION | Claims processing Service code 12 | 3333 QUALITY DRIVE RANCHO CORDOVA, CA 95670 | $136K |
| KAISER FOUNDATION HEALTH PLAN INC. EIN 94-1340523 CLAIMS PROCESSOR/MEDICAL | Other services; Claims processing Service code 12 | 300 LAKESIDE DRIVE KAISER CENTER - 26TH FLOOR OAKLAND, CA 94612 | $0 |
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 | 15,500 | 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. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 15,500 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF CALIFORNIA | 18,807 | $18.1M |
| Vision | VISION SERVICE PLAN | 5,678 | $5.0M |
| Life insurance(3 contracts, 2 carriers) | MINNESOTA LIFE INSURANCE COMPANY | 28,099 | $8.0M |
| Long-term disability | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 16,145 | $3.3M |
| Other(12 contracts, 7 carriers) | DELTA DENTAL OF CALIFORNIA | 28,099 | $33.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 28,099 | — |
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."
No prospect flags tripped on this filing.