| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WOODRUFF-SAWYER & CO3 Filed as: WOODRUFF-SAWYER & COMPANY | 50 CALIFORNIA STREET, FLOOR 12 SAN FRANCISCO, CA 94111 | KAISER FOUNDATION HEALTH PLAN INC | $65K | $0 | $65K | 2.96% |
| PCF INSURANCE SERVICES OF THE WEST3 | 220 WEST 20TH AVENUE SAN MATEO, CA 94403 | KAISER FOUNDATION HEALTH PLAN INC | $44K | $0 | $44K | 2.02% |
| WOODRUFF-SAWYER & CO3 | 50 CALIFORNIA ST FLOOR 12 SAN FRANCISCO, CA 94111 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $45K | — | $45K | 3.23% |
| PCF INSURANCE SERVICES OF THE WEST3 Filed as: PCF INSURANCE SRVCS OF THE WEST LLC | 220 W 20TH AVE SAN MATEO, CA 94403 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $45K | — | $45K | 3.21% |
| ANDREINI & COMPANY3 | 220 W 20TH AVE SAN MATEO, CA 94403 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $42K | — | $42K | 3.02% |
| ANDREINI & COMPANY3 | 220 W 20TH AVE SAN MATEO, CA 94403 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $10K | $0 | $10K | 5.01% |
| WOODRUFF-SAWYER & CO3 Filed as: WOODRUFF SAWYER & CO | 50 CALIFORNIA ST 12TH FL SUITE 1350 SAN FRANCISCO, CA 94111 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $10K | $0 | $10K | 4.99% |
| PCF INSURANCE SERVICES OF THE WEST3 | 213 CONRAD ST NEW ORLEANS, LA 70124 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $6K | $6K | 2.81% |
| PROFESSIONAL GROUP PLANS INC3 Filed as: PROFESSIONAL GROUP PLANS, INC. | 225 WIRELESS BLVD STE 200 HAUPPAUGE, NY 117883914 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $2K | $5K | 2.50% |
| WOODRUFF-SAWYER & CO3 Filed as: WOODRUFF SAWYER & CO | 12TH FL SUITE 1350 SAN FRANCISCO, CA 94111 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $7K | $0 | $7K | 5.06% |
| ANDREINI & COMPANY3 | 220 W 20TH AVE SAN MATEO, CA 94403 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $7K | $0 | $7K | 4.94% |
| PROFESSIONAL GROUP PLANS INC3 Filed as: PROFESSIONAL GROUP PLANS, INC. | 225 WIRELESS BLVD STE 200 HAUPPAUGE, NY 117883914 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $2K | $3K | 2.47% |
| PCF INSURANCE SERVICES OF THE WEST3 | 213 CONRAD ST NEW ORLEANS, LA 70124 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $3K | $3K | 2.35% |
| PCF INSURANCE SERVICES OF THE WEST3 | 220 W 20TH AVE SAN MATEO, CA 944031339 | KAISER FOUNDATION HEALTH PLAN, INC. | $3K | $0 | $3K | 2.61% |
| WOODRUFF-SAWYER & CO3 Filed as: WOODRUFF-SAWYER & COMPANY | 50 CALIFORNIA STREET, FLOOR 12 SAN FRANCISCO, CA 941114646 | KAISER FOUNDATION HEALTH PLAN, INC. | $3K | $0 | $3K | 2.54% |
| PCF INSURANCE SERVICES OF THE WEST3 | 220 WEST 20TH AVENUE SAN MATEO, CA 94403 | SUN LIFE ASSURANCE COMPANY OF CANADA | $5K | — | $5K | 5.49% |
| ANDREINI & COMPANY3 | 220 W 20TH AVE SAN MATEO, CA 94403 | SUN LIFE ASSURANCE COMPANY OF CANADA | $5K | — | $5K | 5.28% |
| WOODRUFF-SAWYER & CO3 | 50 CALIFORNIA ST FLOOR 12 SAN FRANCISCO, CA 94111 | SUN LIFE ASSURANCE COMPANY OF CANADA | $4K | — | $4K | 3.92% |
| PROFESSIONAL GROUP PLANS INC3 | 225 WIRELESS BLVD STE 200 HAUPPAUGE, NY 11788 | SUN LIFE ASSURANCE COMPANY OF CANADA | $378 | — | $378 | 0.40% |
| ANDREINI & COMPANY3 | 220 W 20TH AVE SAN MATEO, CA 94403 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | $0 | $1K | 5.01% |
| WOODRUFF-SAWYER & CO3 Filed as: WOODRUFF SAWYER & CO | 50 CALIFORNIA ST 12TH FL SUITE 1350 SAN FRANCISCO, CA 94111 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | $0 | $1K | 4.99% |
| PROFESSIONAL GROUP PLANS INC3 Filed as: PROFESSIONAL GROUP PLANS, INC. | 225 WIRELESS BLVD STE 200 HAUPPAUGE, NY 117883914 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $363 | $353 | $716 | 2.50% |
| PCF INSURANCE SERVICES OF THE WEST3 | 213 CONRAD ST NEW ORLEANS, LA 70124 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $414 | $414 | 1.45% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO. EIN 59-1031071 CLAIMS ADMINISTRATION | Named fiduciary; Contract Administrator; Direct payment from the plan; Float revenue; Non-monetary compensation; Claims processing; Participant communication; Other services Service code 12 | — | $334K |
| CLIFTONLARSONALLEN LLP EIN 41-0746749 ACCOUNTANT | Accounting (including auditing) Service code 10 | — | $35K |
| CIGNA HEALTH & LIFE INSURANCE CO. | Contract Administrator; Direct payment from the plan; Other services; Participant communication; Claims processing; Non-monetary compensation; Named fiduciary; Float revenue Service code 12 | — | $0 |
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 | 534 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 538 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC | 454 | $2.3M |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 534 | $199K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 534 | $140K |
| Prescription drug(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC | 454 | $2.3M |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 336 | $1.4M |
| Other(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 534 | $124K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 534 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.