| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WOODRUFF-SAWYER & CO3 | 50 CALIFORNIA STREET 12TH FLOOR SAN FRANCISCO, CA 94111 | KAISER FOUNDATION HEALTH PLAN INC | $17K | — | $17K | 4.10% |
| WOODRUFF-SAWYER & CO3 | 50 CALIFORNIA STREET 12TH FLOOR SAN FRANCISCO, CA 94111 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $32K | $1K | $33K | 10.26% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICES | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 91361 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | — | $12K | $12K | 3.62% |
| PETROCELLI JR, ROBERT H3 | 10 BYRD STEET RYE, NY 10580 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | — | $6K | 3.62% |
| YOO, JOYCE3 | 1425 W FULLERTON AVE CHICAGO, IL 60614 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | — | $6K | 3.62% |
| NYLIFE SECURITIES LLC3 | 51 MADISON AVE ROOM 251 NEW YORK, NY 10010 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 1.00% |
| WOODRUFF-SAWYER & CO3 | 50 CALIFORNIA STREET, FLOOR 12 SAN FRANCISCO, CA 94111 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $6K | — | $6K | 5.26% |
| WOODRUFF-SAWYER & CO3 | 50 CALIFORNIA STREET 12TH FLOOR SAN FRANCISCO, CA 94111 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 10.00% |
| PETROCELLI JR, ROBERT H3 | 10 BRYD STREET RYE, NY 10580 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 8.34% |
| YOO, JOYCE3 | 1425 W FULLERTON AVE CHICAGO, IL 60614 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 8.34% |
| NYLIFE SECURITIES LLC3 | 51 MADISON AVE ROOM 251 NEW YORK, NY 10010 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $120 | $120 | 1.00% |
| WOODRUFF-SAWYER & CO3 | 50 CALIFORNIA STREET 12TH FLOOR SAN FRANCISCO, CA 94111 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $833 | — | $833 | 10.00% |
| VARIOUS - SEE ATTACHED3 Filed as: VARIOUS SEE ATTACHED AFLAC SCHEDULE | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $942 | — | $942 | 13.03% |
| WOODRUFF-SAWYER & CO3 | 50 CALIFORNIA STREET 12TH FLOOR SAN FRANCISCO, CA 94111 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $690 | — | $690 | 10.01% |
| WOODRUFF-SAWYER & CO3 | 50 CALIFORNIA STREET 12TH FLOOR SAN FRANCISCO, CA 94111 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $240 | — | $240 | 10.00% |
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 | 275 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 275 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 65 | $533K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 237 | $324K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 237 | $324K |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 275 | $176K |
| Short-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 275 | $181K |
| Long-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 275 | $175K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 65 | $533K |
| Other(4 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 275 | $189K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 275 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.