| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WOODRUFF-SAWYER & CO3 Filed as: WOODRUFF-SAWYER AND COMPANY | 50 CALIFORNIA STREET, 12TH FLOOR SAN FRANCISCO, CA 94111 | BLUE CROSS OF CALIFORNIA | $79K | — | $79K | 4.33% |
| WOODRUFF-SAWYER & CO3 Filed as: WOODRUFF-SAWYER AND COMPANY | 50 CALIFORNIA STREET, 12TH FLOOR SAN FRANCISCO, CA 94111 | KAISER FOUNDATION HEALTH PLAN INC | $10K | $494 | $10K | 5.81% |
| WOODRUFF-SAWYER & CO3 Filed as: WOODRUFF-SAWYER AND COMPANY | 50 CALIFORNIA STREET, 12TH FLOOR SAN FRANCISCO, CA 94111 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $9K | — | $9K | 5.00% |
| WOODRUFF-SAWYER & CO3 Filed as: WOODRUFF-SAWYER AND COMPANY | 50 CALIFORNIA STREET, 12TH FLOOR SAN FRANCISCO, CA 94111 | SUN LIFE ASSURANCE COMPANY OF CANADA | $3K | — | $3K | 7.75% |
| WOODRUFF-SAWYER & CO3 Filed as: WOODRUFF-SAWYER AND COMPANY | 50 CALIFORNIA STREET, 12TH FLOOR SAN FRANCISCO, CA 94111 | TRANSAMERICA LIFE INSURANCE COMPANY | $4K | — | $4K | 10.02% |
| KIMBERLY A SCHOTT3 Filed as: KIMBERLY A. SCHOTT | 88 ROWLAND WAY, SUITE 180 NOVATO, CA 94945 | TRANSAMERICA LIFE INSURANCE COMPANY | $981 | — | $981 | 2.61% |
| CLAY W CAMPBELL3 Filed as: CLAY CAMPBELL | 111 WEST OCEAN BOULEVARD, 4TH FLOOR LONG BEACH, CA 90802 | TRANSAMERICA LIFE INSURANCE COMPANY | $9 | — | $9 | 0.02% |
| MOISES VILLALOBOS3 | 6122 WOODLAWN AVENUE MAYWOOD, CA 90270 | TRANSAMERICA LIFE INSURANCE COMPANY | $8 | — | $8 | 0.02% |
| RAMONA MARGARET DALY3 | 402 CAMINO BANDERA SAN CLEMENTE, CA 92673 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $158 | — | $158 | 2.85% |
| WOODRUFF-SAWYER & CO3 Filed as: WOODRUFF-SAWYER AND COMPANY | 50 CALIFORNIA STREET, 12TH FLOOR SAN FRANCISCO, CA 94111 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $73 | — | $73 | 1.32% |
| BRIAN YERVANT AKIAN3 | 503 SPRINGBROOK NORTH IRVINE, CA 92614 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $65 | — | $65 | 1.17% |
| BIJAN NAHAI3 | 465 SOUTH BEVERLY DRIVE BEVERLY HILLS, CA 90212 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $54 | — | $54 | 0.97% |
| MJ INSURANCE3 Filed as: MIKE MCCORMICK AND VARIOUS AGENTS | 348 SOUTH STRONGS COURT SALT LAKE CITY, UT 84102 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $41 | — | $41 | 0.74% |
| JOHN D EVANGELISTA3 Filed as: JOHN D. EVANGELISTA | 26111 ANTONIO PARKWAY RANCHO SANTA MARGARITA, CA 92688 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $22 | — | $22 | 0.40% |
| MICHAEL F FAHEY III3 Filed as: MICHAEL F. FAHEY | 411 AVENIDA ADOBE SAN CLEMENTE, CA 92672 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $18 | — | $18 | 0.32% |
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 | 307 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 311 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 357 | $2.0M |
| Dental(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 357 | $2.0M |
| Vision | BLUE CROSS OF CALIFORNIA | 357 | $1.8M |
| Life insurance(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 357 | $1.9M |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 153 | $45K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 153 | $45K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 357 | $2.0M |
| Other(3 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 357 | $1.9M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 357 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.