| 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 | PROVIDENCE HEALTH PLAN | $11K | — | $11K | 1.84% |
| WOODRUFF-SAWYER & CO3 Filed as: WOODRUFF-SAWYER AND COMPANY | 50 CALIFORNIA STREET, 12TH FLOOR SAN FRANCISCO, CA 94111 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $9K | — | $9K | 2.00% |
| WOODRUFF-SAWYER & CO3 Filed as: WOODRUFF-SAWYER AND COMPANY | 50 CALIFORNIA STREET, 12TH FLOOR SAN FRANCISCO, CA 94111 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | — | $4K | 12.40% |
| ASSUREX3 Filed as: ASSUREX AGENCY, INC. | 175 SOUTH THIRD STREET, SUITE 800 COLUMBUS, OH 43215 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $440 | $440 | 1.50% |
| WOODRUFF-SAWYER & CO3 Filed as: WOODRUFF-SAWYER AND COMPANY, INC. | 50 CALIFORNIA STREET, 12TH FLOOR SAN FRANCISCO, CA 94111 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $375 | — | $375 | 6.28% |
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 | 292 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 300 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | PROVIDENCE HEALTH PLAN | 96 | $1.1M |
| Dental | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 66 | $444K |
| Vision(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 88 | $450K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 161 | $29K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 161 | $29K |
| Prescription drug(2 contracts, 2 carriers) | PROVIDENCE HEALTH PLAN | 96 | $1.1M |
| Other | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 161 | $29K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 161 | — |
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.