| 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 | $55K | $2K | $57K | 3.08% |
| WOODRUFF-SAWYER & CO3 Filed as: WOODRUFF-SAWYER AND COMPANY | 50 CALIFORNIA STREET, 12TH FLOOR SAN FRANCISCO, CA 94111 | METROPOLITAN LIFE INSURANCE COMPANY | $21K | $2K | $23K | 10.84% |
| ASSUREX3 Filed as: ASSUREX AGENCY, INC. | 175 SOUTH 3RD STREET, SUITE 800 COLUMBUS, OH 43215 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | — | $4K | 1.64% |
| GRIFFIN, STEVEN, RAY3 | 2000 MORRIS AVENUE, SUITE 1400 BIRMINGHAM, AL 35203 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $776 | — | $776 | 3.60% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CORPORATE SERVICES | 3470 MOUNT DIABLO BOULEVARD SUITE A100 LAFAYETTE, CA 94549 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $301 | — | $301 | 1.40% |
| WOODRUFF-SAWYER & CO3 Filed as: WOODRUFF-SAWYER AND COMPANY | 50 CALIFORNIA STREET, 12TH FLOOR SAN FRANCISCO, CA 94111 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $263 | — | $263 | 1.22% |
| ASSUREX3 Filed as: ASSUREX AGENCY, INC. | 175 SOUTH 3RD STREET, SUITE 800 COLUMBUS, OH 43215 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $11 | $11 | 0.05% |
| WOODRUFF-SAWYER & CO3 Filed as: WOODRUFF-SAWYER AND COMPANY | 50 CALIFORNIA STREET, 12TH FLOOR SAN FRANCISCO, CA 94111 | EYEMED VISION CARE | $1K | — | $1K | 9.80% |
| WOODRUFF-SAWYER & CO3 Filed as: WOODRUFF-SAWYER AND COMPANY | 50 CALIFORNIA STREET, 12TH FLOOR SAN FRANCISCO, CA 94111 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $144 | $11 | $155 | 10.76% |
| ASSUREX3 Filed as: ASSUREX AGENCY, INC. | 175 SOUTH 3RD STREET, SUITE 800 COLUMBUS, OH 43215 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $26 | — | $26 | 1.80% |
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 | 213 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 213 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 248 | $1.9M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 326 | $214K |
| Vision | EYEMED VISION CARE | 154 | $11K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 326 | $213K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 46 | $22K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 326 | $213K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 248 | $1.9M |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 326 | $234K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 326 | — |
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.