| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WOODRUFF-SAWYER & CO3 | 50 CALIFORNIA STREET, FLOOR 12 SAN FRANCISCO, CA 94111 | CALIFORNIA PHYSICIANS SERVICE | $59 | $46K | $46K | 3.90% |
| WOODRUFF-SAWYER & CO3 | 50 CALIFORNIA STREET, FLOOR 12 SAN FRANCISCO, CA 94111 | KAISER FOUNDATION HEALTH PLAN INC. | $28K | $884 | $29K | 3.88% |
| WOODRUFF-SAWYER & CO3 | 50 CALIFORNIA STREET 12TH FLOOR SAN FRANCISCO, CA 94111 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $6K | — | $6K | 4.96% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICES | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 91361 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | — | $5K | $5K | 3.97% |
| WOODRUFF-SAWYER & CO3 | 50 CALIFORNIA STREET, FLOOR 12 SAN FRANCISCO, CA 94111 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 8.00% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICES | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 91361 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $899 | $899 | 5.00% |
| VARIOUS - SEE ATTACHED3 Filed as: SEE ATTACHED AFLAC SCHEDULE A | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $3K | — | $3K | 17.62% |
| WOODRUFF-SAWYER & CO3 | 50 CALIFORNIA STREET, FLOOR 12 SAN FRANCISCO, CA 94111 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 10.00% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICES | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 91361 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $714 | $714 | 5.00% |
| WOODRUFF-SAWYER & CO3 | 50 CALIFORNIA STREET, FLOOR 12 SAN FRANCISCO, CA 94111 | EYEMED VISION CARE | $881 | — | $881 | 10.83% |
| WOODRUFF-SAWYER & CO3 | 50 CALIFORNIA STREET, FLOOR 12 SAN FRANCISCO, CA 94111 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $259 | — | $259 | 9.98% |
| REUBEN WARNER ASSOCIATES, INC.5 Filed as: WARNER PACIFIC INSURANCE SERVICES | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 91361 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $130 | $130 | 5.01% |
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 | 117 | 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) | 123 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 139 | $1.9M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 124 | $126K |
| Vision | EYEMED VISION CARE | 182 | $8K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 162 | $14K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 123 | $18K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 139 | $1.9M |
| Other(2 contracts, 2 carriers) | AFLAC | 163 | $19K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 182 | — |
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.