| 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. | $51K | $2K | $53K | 3.18% |
| WOODRUFF-SAWYER & CO3 | 50 CALIFORNIA STREET, FLOOR 12 SAN FRANCISCO, CA 94111 | METROPOLITAN LIFE INSURANCE COMPANY | $14K | $4K | $18K | 9.04% |
| GRIFFIN, STEVEN, RAY3 | 2000 MORRIS AVENUE, SUITE 1400 BIRMINGHAM, AL 35203 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $184 | — | $184 | 2.80% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CA INSURANCE SERVICES, INC | 2300 CONTRA COSTA BLVD, SUITE 600 PLEASANT HILL, CA 94523 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $88 | — | $88 | 1.34% |
| WOODRUFF-SAWYER & CO3 | 50 CALIFORNIA STREET, FLOOR 12 SAN FRANCISCO, CA 94111 | EYEMED VISION CARE | $539 | — | $539 | 10.39% |
| WOODRUFF-SAWYER & CO3 | 50 CALIFORNIA STREET, FLOOR 12 SAN FRANCISCO, CA 94111 | CONCERN EAP | $248 | — | $248 | 5.01% |
| WOODRUFF-SAWYER & CO3 | 50 CALIFORNIA STREET, FLOOR 12 SAN FRANCISCO, CA 94111 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $195 | $82 | $277 | 8.05% |
| JEFF S GURMAN3 | PO BOX 3868 MANHATTAN BEACH, CA 90266 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $282 | — | $282 | 50.72% |
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 | 142 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 18 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 160 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC. | 160 | $1.7M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 226 | $206K |
| Vision | EYEMED VISION CARE | 47 | $5K |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 226 | $203K |
| Short-term disability(2 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 26 | $7K |
| Long-term disability(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 226 | $203K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC. | 160 | $1.7M |
| Other(4 contracts, 4 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 226 | $214K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 226 | — |
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.