| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | 801 S FIGUEROA ST STE 800 LOS ANGELES, CA 90017 | KAISER FOUNDATION HEALTH PLAN, INC. | $50K | — | $50K | 4.83% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | 1144 W WASHINGTON ST TEMPE, AZ 85281 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $59K | $16K | $75K | 12.69% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | PO BOX 101162 PASADENA, CA 91189 | DELTA DENTAL OF CALIFORNIA | $17K | — | $17K | 5.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | 2010 MAIN ST SUITE 1050 IRVINE, CA 92614 | AETNA LIFE INSURANCE CO. | $15K | — | $15K | 18.21% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | PO BOX 101162 PASADENA, CA 91189 | DELTA DENTAL OF CALIFORNIA | $480 | — | $480 | 4.98% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | PO BOX 730054 DALLAS, TX 75373 | METLIFE LEGAL PLANS | $587 | — | $587 | 9.91% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | 4565 PAYSHERE CIRCLE CHICAGO, IL 60674 | METLIFE LEGAL PLANS | — | $63 | $63 | 1.06% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | 62877 COLLECTIONS DR CHICAGO, IL 60693 | METLIFE LEGAL PLANS | — | $37 | $37 | 0.62% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS | 801 S. FIGUEROA STREET SUITE 700 LOS ANGELES, CA 90017 | METLIFE LEGAL PLANS | — | $22 | $22 | 0.37% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | PO BOX 730054 DALLAS, TX 75373 | METROPOLITAN GENERAL INSURANCE COMPANY | $302 | — | $302 | 13.03% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | 4565 PAYSPHERE CIRCLE CHICAGO, TX 60674 | METROPOLITAN GENERAL INSURANCE COMPANY | — | $63 | $63 | 2.72% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | 62877 COLLECTIONS DR CHICAGO, IL 60693 | METROPOLITAN GENERAL INSURANCE COMPANY | — | $39 | $39 | 1.68% |
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 | 612 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 7 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 621 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN, INC. | 144 | $1.0M |
| Dental(2 contracts) | DELTA DENTAL OF CALIFORNIA | 841 | $355K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 751 | $64K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 915 | $589K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 915 | $589K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 915 | $589K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN, INC. | 144 | $1.0M |
| Other(5 contracts, 5 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 915 | $677K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 915 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.