| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WOODRUFF-SAWYER & CO3 Filed as: WOODRUFF-SAWYER & CO. | 50 CALIFORNIA ST. FLOOR 12 SAN FRANCISCO, CA 94111 | CALIFORNIA PHYSICIANS' SERVICE | $3K | $19K | $23K | 1.93% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES | OF CALIFORNIA, INC. 3697 MT. DIABLO BLVD. SUITE 100 LAFAYETTE, CA 94549 | CALIFORNIA PHYSICIANS' SERVICE | — | $10K | $10K | 0.81% |
| WOODRUFF-SAWYER & CO3 Filed as: WOODRUFF-SAWYER & COMPANY | 50 CALIFORNIA ST. FLOOR 12 SAN FRANCISCO, CA 94111 | KAISER FOUNDATION HEALTH PLAN INC. | $11K | $1K | $12K | 4.84% |
| WOODRUFF-SAWYER & CO3 Filed as: WOODRUFF-SAWYER & CO. | 50 CALIFORNIA ST. FLOOR 12 SAN FRANCISCO, CA 94111 | BLUE SHIELD OF CALIFORNIA LIFE HEALTH INSURANCE COMPANY | $395 | — | $395 | 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 | 228 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 228 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 191 | $1.4M |
| Dental | CALIFORNIA PHYSICIANS' SERVICE | 191 | $1.2M |
| Vision | CALIFORNIA PHYSICIANS' SERVICE | 191 | $1.2M |
| Life insurance | BLUE SHIELD OF CALIFORNIA LIFE HEALTH INSURANCE COMPANY | 228 | $4K |
| Prescription drug | CALIFORNIA PHYSICIANS' SERVICE | 191 | $1.2M |
| Other | BLUE SHIELD OF CALIFORNIA LIFE HEALTH INSURANCE COMPANY | 228 | $4K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 228 | — |
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.