| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC | COMMISSION LOCKBOX 28852 NEW YORK, NY 10087 | AETNA LIFE INSURANCE CO. | $144K | — | $144K | 3.02% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC | COMMISSION LOCKBOX 28852 NEW YORK, NY 10087 | AETNA OF CALIFORNIA, INC. | $153K | — | $153K | 3.26% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC | PO BOX 28852P NEW YORK, NY 100878852 | KAISER FOUNDATION HEALTH PLAN INC | $32K | — | $32K | 3.15% |
| NATIONAL ACCOUNT SERVICES3 | 11111 SANTA MONICA BLVD SUITE 1150 LOS ANGELES, CA 90025 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $21K | $4K | $25K | 6.08% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP NATIONAL ACCOUNT SERV | 7272 E. INDIAN SCHOOL SUITE 415 SCOTTSDALE, AZ 85251 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $23K | $23K | 5.58% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC | PO BOX 28852P NEW YORK, NY 100878852 | KAISER FOUNDATION HEALTH PLAN INC | $10K | — | $10K | 2.70% |
| NATIONAL ACCOUNT SERVICES3 | 11111 SANTA MONICA BLVD SUITE 1150 LOS ANGELES, CA 90025 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $18K | $4K | $22K | 6.09% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP NATIONAL ACCOUNT SERV | 7272 E. INDIAN SCHOOL SUITE 415 SCOTTSDALE, AZ 85251 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $19K | $19K | 5.34% |
| NATIONAL ACCOUNT SERVICES3 | 11111 SANTA MONICA BLVD SUITE 1150 LOS ANGELES, CA 90025 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $10K | $2K | $12K | 6.09% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP NATIONAL ACCOUNT SERV | 7272 E. INDIAN SCHOOL SUITE 415 SCOTTSDALE, AZ 85251 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $12K | $12K | 5.88% |
| NATIONAL ACCOUNT SERVICES3 | 11111 SANTA MONICA BLVD SUITE 1150 LOS ANGELES, CA 90025 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | $829 | $5K | 6.08% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP NATIONAL ACCOUNT SERV | 7272 E. INDIAN SCHOOL SUITE 415 SCOTTSDALE, AZ 85251 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $4K | $4K | 5.53% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DE, LOS ANGELES - CEN | PO BOX 28852 LOCKBOX 28852 NEW YORK, NY 100878852 | EYEMED VISION CARE | $6K | — | $6K | 9.96% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC | COMMISSION LOCKBOX #28852 P.O. BOX 28852 NEW YORK, NY 10087 | HYATT LEGAL PLANS, INC. | $2K | — | $2K | 9.97% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON PENNSYLVANIA, INC. | PO BOX 9102 PHILADELPHIA, PA 191788500 | HYATT LEGAL PLANS, INC. | $0 | $42 | $42 | 0.21% |
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 | 1,115 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 29 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 122 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,266 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | AETNA LIFE INSURANCE CO. | 2,109 | $6.2M |
| Dental | AETNA LIFE INSURANCE CO. | 2,109 | $4.8M |
| Vision | EYEMED VISION CARE | 1,990 | $65K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,638 | $416K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,025 | $203K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,115 | $363K |
| Prescription drug(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC | 321 | $1.4M |
| Other(4 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,638 | $524K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,109 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.