| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WOODRUFF-SAWYER & CO3 | 50 CALIFORNIA STREET, 12TH FLOOR SAN FRANCISCO, CA 94111 | CALIFORNIA PHYSICIANS SERVICE (BLUE SHIELD) | $79 | $125K | $125K | 3.83% |
| WOODRUFF-SAWYER & CO3 | 50 CALIFORNIA STREET, 12TH FLOOR SAN FRANCISCO, CA 94111 | SUN LIFE ASSURANCE COMPANY OF CANADA | $53K | — | $53K | 9.31% |
| WOODRUFF-SAWYER & CO3 | 50 CALIFORNIA STREET, FLOOR 12 SAN FRANCISCO, CA 94111 | KAISER FOUNDATION HEALTH PLAN INC | $12K | — | $12K | 4.60% |
| WOODRUFF-SAWYER & CO3 | 50 CALIFORNIA STREET, 12TH FLOOR SAN FRANCISCO, CA 94111 | KAISER FOUNDATION HEALTH PLAN INC | $8K | — | $8K | 5.44% |
| WOODRUFF-SAWYER & CO3 | 50 CALIFORNIA STREET FLOOR 12 SAN FRANCISCO, CA 94111 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $2K | $1 | $2K | 2.22% |
| JORDAN SHIELDS3 | PO BOX 750004 PETALUMA, CA 94975 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $1K | $30 | $1K | 1.20% |
| REUBEN WARNER ASSOCIATES, INC.3 | 1655 RICHMOND AVENUE STATEN ISLAND, NY 10314 | ACE AMERICAN INSURANCE COMPANY | — | $7K | $7K | 20.00% |
| WOODRUFF-SAWYER & CO3 | 50 CALIFORNIA STREET, SUITE 1200 SAN FRANCISCO, CA 94111 | ACE AMERICAN INSURANCE COMPANY | $5K | — | $5K | 15.00% |
| WOODRUFF-SAWYER & CO3 | 50 CALIFORNIA STREET FLOOR 12 SAN FRANCISCO, CA 94111 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $73 | — | $73 | 1.37% |
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 | 350 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 353 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(6 contracts, 5 carriers) | CALIFORNIA PHYSICIANS SERVICE (BLUE SHIELD) | 384 | $4.2M |
| Dental | SUN LIFE ASSURANCE COMPANY OF CANADA | 350 | $574K |
| Vision | SUN LIFE ASSURANCE COMPANY OF CANADA | 350 | $574K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 350 | $574K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 350 | $574K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 350 | $574K |
| Prescription drug(6 contracts, 5 carriers) | CALIFORNIA PHYSICIANS SERVICE (BLUE SHIELD) | 384 | $4.2M |
| Other(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 350 | $608K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 384 | — |
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."
No prospect flags tripped on this filing.