| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE | 2010 MAIN STREET, SUITE 1050 IRVINE, CA 92614 | UNIVERSITY HEALTH ALLIANCE | $13K | — | $13K | 0.83% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON WEST INS SVCS | 38 EASTWOOD DRIVE SUITE 300 SOUTH BURLINGTON, VT 05403 | KAISER FOUNDATION HEALTH PLAN, INC. | $26K | — | $26K | 3.41% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON | PO BOX 101162 PASADENA, CA 91189 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | — | $4K | 15.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON | PO BOX 101162 PASADENA, CA 91189 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 10.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON | PO BOX 101162 PASADENA, CA 91189 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 24.00% |
| BONNIE PANG MAHALO3 | 1600 KKAPIOLANI BLVD STE 1610 HONOLULU, HI 96814 | EMPLOYEE ASSISTANCE OF THE PACIFIC | $134 | — | $134 | 2.99% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON | PO BOX 101162 PASADENA, CA 91189 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $412 | — | $412 | 24.01% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON | PO BOX 101162 PASADENA, CA 91189 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $397 | — | $397 | 23.99% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON | PO BOX 101162 PASADENA, CA 91189 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $106 | — | $106 | 15.06% |
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 | 339 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 5 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 344 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNIVERSITY HEALTH ALLIANCE | 195 | $2.3M |
| Vision(2 contracts, 2 carriers) | UNIVERSITY HEALTH ALLIANCE | 195 | $2.3M |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 420 | $30K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 47 | $10K |
| Prescription drug(2 contracts, 2 carriers) | UNIVERSITY HEALTH ALLIANCE | 195 | $2.3M |
| Other(6 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 420 | $43K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 420 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.