| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WOODRUFF-SAWYER & CO3 | 50 CALIFORNIA STREET, FLOOR 12 SAN FRANCISCO, CA 94111 | KAISER FOUNDATION HEALTH PLAN INC. | $32K | — | $32K | 3.42% |
| WOODRUFF-SAWYER & CO3 | 50 CALIFORNIA STREET 12TH FLOOR SAN FRANCISCO, CA 94111 | DELTA DENTAL OF CALIFORNIA | $6K | — | $6K | 5.00% |
| WOODRUFF-SAWYER & CO3 | 50 CALIFORNIA STREET, FLOOR 12 SAN FRANCISCO, CA 94111 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 8.82% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SVCS INC. | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 91361 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 5.51% |
| VARIOUS - SEE ATTACHED3 Filed as: SEE ATTACHED AFLAC SCHEDULE A | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $2K | $56 | $2K | 9.97% |
| WOODRUFF-SAWYER & CO3 | 50 CALIFORNIA STREET, FLOOR 12 SAN FRANCISCO, CA 94111 | EYEMED VISION CARE | $949 | — | $949 | 9.93% |
| WOODRUFF-SAWYER & CO3 | 50 CALIFORNIA STREET, FLOOR 12 SAN FRANCISCO, CA 94111 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $262 | — | $262 | 10.96% |
| REUBEN WARNER ASSOCIATES, INC.5 Filed as: WARNER PACIFIC INSURANCE SERVICES | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 91361 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $131 | — | $131 | 5.48% |
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 | 113 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 114 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC. | 163 | $936K |
| Dental | DELTA DENTAL OF CALIFORNIA | 314 | $129K |
| Vision | EYEMED VISION CARE | 398 | $10K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 177 | $15K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 127 | $21K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC. | 163 | $936K |
| Other(2 contracts, 2 carriers) | AFLAC | 177 | $22K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 398 | — |
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.