| 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 | KAISER FOUNDATION HEALTH PLAN INC | $10K | — | $10K | 0.53% |
| WOODRUFF-SAWYER & CO3 Filed as: WOODRUFF-SAWYER AND COMPANY | 50 CALIFORNIA STREET, 12TH FLOOR SAN FRANCISCO, CA 94111 | BLUE CROSS OF CALIFORNIA | $5K | — | $5K | 0.46% |
| WOODRUFF-SAWYER & CO3 Filed as: WOODRUFF-SAWYER AND COMPANY | 50 CALIFORNIA STREET, 12TH FLOOR SAN FRANCISCO, CA 94111 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $546 | $4K | 0.95% |
| ROBERT C PLACAK & ASSOCIATES3 Filed as: ROBERT C. PLACAK AND ASSOCIATES INC | 790 MISSION AVENUE SAN RAFAEL, CA 94901 | METROPOLITAN LIFE INSURANCE COMPANY | $597 | — | $597 | 0.16% |
| ROBERT C PLACAK & ASSOCIATES3 Filed as: ROBERT C PLACAK AND ASSOCIATES, INC | 790 MISSION AVENUE SAN RAFAEL, CA 94901 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 4.53% |
| BRETT WELTY INSURANCE AGENCY INC3 Filed as: BRETT WELTY INSURANCE AGENCY, INC. | 5675 RUFFIN ROAD SAN DIEGO, CA 92123 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $90 | $1K | 2.65% |
| MICHAEL JAMES LEBRANE3 | 808 EAST 5TH AVENUE SAN MATEO, CA 94402 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $65 | $1K | 2.54% |
| CLIENT BENEFIT INSURANCE SERVICES3 | 5675 RUFFIN ROAD SAN DIEGO, CA 92123 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $826 | $65 | $891 | 2.08% |
| CATHERINE LISA LUKE3 | 1922 THE ALAMEDA, SUITE 212 SAN JOSE, CA 95126 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $519 | $312 | $831 | 1.94% |
| LORI LAINE3 | 35837 CARTER STREET YUCAIPA, CA 92399 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $558 | $56 | $614 | 1.43% |
| WOODRUFF-SAWYER & CO3 Filed as: WOODRUFF-SAWYER AND VARIOUS AGENTS | 50 CALIFORNIA STREET, 12TH FLOOR SAN FRANCISCO, CA 94111 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $429 | $3 | $432 | 1.01% |
| WOODRUFF-SAWYER & CO3 Filed as: WOODRUFF-SAWYER AND COMPANY | 50 CALIFORNIA STREET, 12TH FLOOR SAN FRANCISCO, CA 94111 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 2.96% |
| WOODRUFFY-SAWYER AND COMPANY3 | 50 CALIFORNIA STREET, 12TH FLOOR SAN FRANCISCO, CA 94111 | SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION | $96 | $17 | $113 | 1.14% |
| ROBERT C PLACAK & ASSOCIATES3 Filed as: ROBERT C. PLACAK AND ASSOCIATES INC | 790 MISSION AVENUE SAN RAFAEL, CA 94901 | SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION | $36 | — | $36 | 0.36% |
| WOODRUFF-SAWYER & CO3 Filed as: WOODRUFF-SAWYER AND COMPANY | 50 CALIFORNIA STREET, 12TH FLOOR SAN FRANCISCO, CA 94111 | FEDERAL INSURANCE COMPANY | $225 | — | $225 | 15.00% |
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 | 446 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 11 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 457 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 386 | $3.1M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 830 | $387K |
| Vision | VISION SERVICE PLAN | 370 | $39K |
| Life insurance(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 198 | $1.2M |
| Short-term disability | BLUE CROSS OF CALIFORNIA | 198 | $1.2M |
| Long-term disability | BLUE CROSS OF CALIFORNIA | 198 | $1.2M |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 386 | $3.1M |
| Other(4 contracts, 4 carriers) | BLUE CROSS OF CALIFORNIA | 446 | $1.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 830 | — |
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."
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.