| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC. | LOCKBOX #28852, PO BOX 28852 NEW YORK, NY 100878852 | AETNA LIFE INSURANCE CO. | $165K | — | $165K | 2.17% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC. | LOCKBOX #28852, PO BOX 28852 NEW YORK, NY 100878852 | AETNA HEALTH, INC. | $179K | $44K | $223K | 3.08% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC. | LOCKBOX #28852, PO BOX 28852 NEW YORK, NY 100878852 | KAISER FOUNDATION HEALTH PLAN INC | $53K | — | $53K | 3.04% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC. | LOCKBOX #28852, PO BOX 28852 NEW YORK, NY 100878852 | KAISER FOUNDATION HEALTH PLAN INC | $23K | — | $23K | 3.16% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 11111 SANTA MONICA BLVD SUITE 1150 LOS ANGELES, CA 90025 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $43K | $34K | $77K | 11.12% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 11111 SANTA MONICA BLVD SUITE 1150 LOS ANGELES, CA 90025 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $39K | $31K | $70K | 11.22% |
| ACRISURE LLC3 Filed as: ACCRISURE OF CALIFORNIA LLC | 11111 SANTA MONICA BLVD SUITE 1150 LOS ANGELES, CA 90025 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $22K | $17K | $39K | 11.22% |
| ACRISURE LLC3 Filed as: ACCRISURE OF CALIFORNIA LLC | 11111 SANTA MONICA BLVD SUITE 1150 LOS ANGELES, CA 90025 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $8K | $6K | $14K | 11.29% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC. | LOCKBOX #28852 PO BOX 28852 NEW YORK, NY 100878852 | EYEMED VISION CARE | $10K | — | $10K | 9.90% |
| WILLIS TOWERS WATSON US LLC4 Filed as: TOWERS WATSON DELAWARE INC. | LOCKBOX #28852, PO BOX 28852 NEW YORK, NY 100878852 | HYATT LEGAL PLANS, INC. | $4K | $137 | $4K | 10.38% |
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 | 1,323 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 24 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 93 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,440 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | AETNA LIFE INSURANCE CO. | 2,346 | $10.0M |
| Dental | AETNA LIFE INSURANCE CO. | 2,346 | $7.6M |
| Vision | EYEMED VISION CARE | 2,133 | $102K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,882 | $694K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,185 | $349K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,289 | $626K |
| Prescription drug(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC | 388 | $2.4M |
| Other(4 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,882 | $864K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,346 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.