| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | DEPT 133667 PO BOX 3900 SAN FRANCISCO, CA 94139 | AETNA LIFE INSURANCE COMPANY | $285K | $58K | $343K | 2.06% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | DEPT 133667 PO BOX 3900 SAN FRANCISCO, CA 94139 | AETNA HEALTH INC | $53K | — | $53K | 1.29% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 777 S FIGUEROA STREET SUITE 2100 LOS ANGELES, CA 90017 | DELTA DENTAL OF CALIFORNIA | $56K | — | $56K | 3.49% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | DEPT 133667 PO BOX 3900 SAN FRANCISCO, CA 94139 | DELTA DENTAL OF CALIFORNIA | $25K | — | $25K | 1.54% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | PO BOX 39000 SAN FRANCISCO, CA 94139 | VISION SERVICE PLAN | $4K | — | $4K | 1.97% |
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 | 1,550 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 91 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,641 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | AETNA LIFE INSURANCE COMPANY | 2,264 | $16.7M |
| Dental | DELTA DENTAL OF CALIFORNIA | 1,597 | $1.6M |
| Vision(2 contracts, 2 carriers) | VISION SERVICE PLAN | 1,587 | $247K |
| Life insurance | AETNA LIFE INSURANCE COMPANY | 2,264 | $16.6M |
| Short-term disability | AETNA LIFE INSURANCE COMPANY | 2,264 | $16.6M |
| Long-term disability | AETNA LIFE INSURANCE COMPANY | 2,264 | $16.6M |
| Other(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 2,264 | $16.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,264 | — |
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.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.