| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA INC | PO BOX 101162 PASADENA, CA 91189 | BLUE CROSS OF CALIFORNIA | $76K | $10K | $86K | 2.21% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS | 801 S FIGUEROA ST, STE 700 LOS ANGELES, CA 90017 | UNITED HEALTHCARE INSURANCE COMPANY | $77K | — | $77K | 3.26% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA INC | PO BOX 101162 PASADENA, CA 91189 | DELTA DENTAL OF CALIFORNIA | $3K | — | $3K | 1.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SERVICES OF CA | 801 S. FIGUEROA STREET, SUITE 700 LOS ANGELES, CA 90017 | AETNA LIFE INSURANCE COMPANY | $4K | $2K | $6K | 5.47% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SERVICES OF CA | PO BOX 101162 PASADENA, CA 91189 | VISION SERVICE PLAN | $1K | — | $1K | 4.59% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SERVICES OF CA. | 801 S. FIGUEROA STREET, SUITE 700 LOS ANGELES, CA 90017 | CHARTIS MES VISION | $1K | — | $1K | 7.03% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA INC. | 801 S FIGUEROA ST, SUITE 700 LOS ANGELES, CA 90017 | GERBER LIFE INSURANCE CO. MES VISION | $1K | — | $1K | 5.00% |
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 | 449 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 452 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 470 | $6.2M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF CALIFORNIA | 323 | $402K |
| Vision(3 contracts, 3 carriers) | VISION SERVICE PLAN | 283 | $72K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 470 | — |
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.