| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WOODRUFF-SAWYER & CO3 Filed as: WOODRUFF SAWYER & CO. | 50 CALIFORNIA STREET, 12TH FLOOR SAN FRANCISCO, CA 94111 | KAISER FOUNDATION HEALTH PLAN, INC. | $28K | $130 | $28K | 2.56% |
| ALLIANT INSURANCE SERVICES, INC.3 | PO BOX 8299 PASADENA, CA 91109 | KAISER FOUNDATION HEALTH PLAN, INC. | $10K | $0 | $10K | 0.92% |
| WOODRUFF-SAWYER & CO3 Filed as: WOODRUFF SAWYER & CO. | 50 CALIFORNIA STREET, 12TH FLOOR SUITE 1350 SAN FRANCISCO, CA 94111 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $0 | $2K | 4.16% |
| BENEUSA LLC3 | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 91361 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $613 | $382 | $995 | 2.54% |
| ALLIANT INSURANCE SERVICES, INC.3 | 701 B STREET, 6TH FLOOR SAN DIEGO, CA 92101 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $215 | $0 | $215 | 0.55% |
| MINES INSURANCE SERVICES INC3 | 1519 BARTH AVENUE RICHMOND, CA 94806 | AFLAC | $841 | $0 | $841 | 4.23% |
| WOODRUFF-SAWYER & CO3 Filed as: WOODRUFF SAWYER & CO | 220 BUSH STREET, 7TH FLOOR SAN FRANCISCO, CA 94104 | AFLAC | $600 | $0 | $600 | 3.02% |
| MJ INSURANCE3 Filed as: PETER SARANTIS AND VARIOUS AGENTS | 5509 SNOWBRUSH DRIVE ROCKLIN, CA 95677 | AFLAC | $279 | $0 | $279 | 1.40% |
| SERGIO I GARCIA3 Filed as: SERGIO GARCIA | 8001 NW 41ST STREET, APARTMENT 310 DORAL, FL 33166 | AFLAC | $100 | $0 | $100 | 0.50% |
| BRITTANY MAAS3 | 127 ADELAIDE XING ACWORTH, GA 30101 | AFLAC | $91 | $0 | $91 | 0.46% |
| GUILLERMO H PALOMINO3 Filed as: GUILLERMO PALOMINO | 14224 N 26TH DRIVE PHOENIX, AZ 85023 | AFLAC | $82 | $0 | $82 | 0.41% |
| LARS J RONTEN3 Filed as: LARS RONTEN | 3178 SOFIA DRIVE LINCOLN, CA 95648 | AFLAC | $76 | $0 | $76 | 0.38% |
| WOODRUFF-SAWYER & CO3 Filed as: WOODRUFF SAWYER & CO. | 50 CALIFORNIA STREET, 12TH FLOOR SAN FRANCISCO, CA 94111 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | $765 | $0 | $765 | 8.92% |
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 | 152 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 154 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 164 | $1.1M |
| Vision | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | 207 | $9K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 152 | $39K |
| Short-term disability | AFLAC | 14 | $20K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 152 | $39K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 164 | $1.1M |
| Other(3 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 152 | $62K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 207 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.