| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WOODRUFF-SAWYER & CO3 Filed as: WOODRUFF-SAWYER & CO. | 50 CALIFORNIA STREET, FLOOR 12 SAN FRANCISCO, CA 94111 | CALIFORNIA PHYSICIANS' SERVICE (BLUE SHIELD OF CALIFORNIA) | $27K | $2K | $29K | 3.45% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | CALIFORNIA PHYSICIANS' SERVICE (BLUE SHIELD OF CALIFORNIA) | $14K | — | $14K | 1.70% |
| WOODRUFF-SAWYER & CO3 Filed as: WOODRUFF-SAWYER & CO. | 50 CALIFORNIA STREET, FLOOR 12 SAN FRANCISCO, CA 94111 | KAISER FOUNDATION HEALTH PLAN INC. | $4K | $351 | $4K | 3.46% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | KAISER FOUNDATION HEALTH PLAN INC. | $1K | $4 | $1K | 0.91% |
| WOODRUFF-SAWYER & CO3 Filed as: WOODRUFF-SAWYER & CO. | 50 CALIFORNIA STREET, FLOOR 12 SAN FRANCISCO, CA 94111 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $1K | $19 | $1K | 3.19% |
| VARIOUS - SEE ATTACHED3 | C/O AFLAC 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $3K | $133 | $4K | 16.51% |
| WOODRUFF-SAWYER & CO3 Filed as: WOODRUFF-SAWYER & CO. | 50 CALIFORNIA STREET, FLOOR 12 SAN FRANCISCO, CA 94111 | UNION SECURITY INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| WOODRUFF-SAWYER & CO3 Filed as: WOODRUFF-SAWYER & CO. | 50 CALIFORNIA STREET, FLOOR 12 SAN FRANCISCO, CA 94111 | UNION SECURITY INSURANCE COMPANY | $915 | — | $915 | 8.51% |
| WOODRUFF-SAWYER & CO3 Filed as: WOODRUFF-SAWYER & CO. | 50 CALIFORNIA STREET, FLOOR 12 SAN FRANCISCO, CA 94111 | BLUE SHIELD OF CALIFORNIA LIFE & HEALTH INSURANCE COMPANY | $612 | — | $612 | 6.74% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | BLUE SHIELD OF CALIFORNIA LIFE & HEALTH INSURANCE COMPANY | $296 | — | $296 | 3.26% |
| WOODRUFF-SAWYER & CO3 Filed as: WOODRUFF-SAWYER & CO. | 50 CALIFORNIA STREET, FLOOR 12 SAN FRANCISCO, CA 94111 | UNION SECURITY INSURANCE COMPANY | $729 | — | $729 | 9.40% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | UNION SECURITY INSURANCE COMPANY | $49 | — | $49 | 0.63% |
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 | 82 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 88 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | CALIFORNIA PHYSICIANS' SERVICE (BLUE SHIELD OF CALIFORNIA) | 62 | $1.0M |
| Dental | CALIFORNIA PHYSICIANS' SERVICE (BLUE SHIELD OF CALIFORNIA) | 62 | $849K |
| Vision | CALIFORNIA PHYSICIANS' SERVICE (BLUE SHIELD OF CALIFORNIA) | 62 | $849K |
| Life insurance(2 contracts, 2 carriers) | UNION SECURITY INSURANCE COMPANY | 164 | $20K |
| Short-term disability(2 contracts, 2 carriers) | AFLAC | 14 | $30K |
| Long-term disability | UNION SECURITY INSURANCE COMPANY | 20 | $21K |
| Prescription drug(3 contracts, 3 carriers) | CALIFORNIA PHYSICIANS' SERVICE (BLUE SHIELD OF CALIFORNIA) | 62 | $1.0M |
| Other(3 contracts, 3 carriers) | AFLAC | 164 | $42K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 164 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.