| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WOODRUFF-SAWYER & CO3 Filed as: WOODRUFF-SAWYER & CO. | 50 CALIFORNIA ST FL 12 SAN FRANCISCO, CA 94111 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $24K | $24K | 5.88% |
| WOODRUFF-SAWYER & CO3 Filed as: WOODRUFF-SAWYER & CO. | 50 CALIFORNIA ST FL 12 SAN FRANCISCO, CA 94111 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $21K | $21K | 5.00% |
| WOODRUFF-SAWYER & CO3 | 50 CALIFORNIA STREET 12TH FL SUITE 1350 SAN FRANCISCO, CA 94111 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $9K | $2K | $11K | 11.85% |
| WOODRUFF-SAWYER & CO3 | PO BOX 609 SANTA BARBARA, CA 93102 | STARMOUNT LIFE INSURANCE COMPANY | $5K | $1K | $6K | 8.83% |
| WOODRUFF-SAWYER & CO3 | 50 CALIFORNIA ST FL 12 SAN FRANCISCO, CA 94111 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $5K | $484 | $5K | 15.98% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $495 | $4K | 13.44% |
| ASSUREX3 | 175 SOUTH 3RD STREET STE 800 COLUMBUS, OH 43215 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $404 | $404 | 1.21% |
| WOODRUFF-SAWYER & CO3 | PO BOX 609 SANTA BARBARA, CA 93102 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $156 | — | $156 | 0.47% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | PO BOX 6030 PASEDENA, CA 91102 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $93 | — | $93 | 0.28% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY | 9171 TOWNE CENTRE STE 500 SAN DIEGO, CA 92122 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $57 | — | $57 | 0.17% |
| WOODRUFF-SAWYER & CO3 | 50 CALIFORNIA STREET, 12TH FLOOR SAN FRANCISCO, CA 94111 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | $2K | $4K | 15.48% |
| WOODRUFF-SAWYER & CO3 | 50 CALIFORNIA STREET 12TH FL SUITE 1350 SAN FRANCISCO, CA 94111 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $324 | $2K | 11.85% |
| WOODRUFF-SAWYER & CO3 | 50 CALIFORNIA STREET 12TH FL SUITE 1350 SAN FRANCISCO, CA 94111 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | $290 | $2K | 11.99% |
| JESSE RAMOS4 | 7331 SHELBY LN #26 RANCHO CUCAMONGA, CA 91739 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $2K | — | $2K | 14.58% |
| HUB INTERNATIONAL MIDWEST LIMITED4 Filed as: BOLTON & COMPANY | PO BOX 6030 PASADENA, CA 91102 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $152 | — | $152 | 1.16% |
| LINDA E. BOWDEN4 Filed as: LINDA E BOWDEN | 1334 E CHANDLER BLVD STE D-73 PHOENIX, AZ 85048 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $41 | — | $41 | 0.31% |
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 | 677 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 26 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 703 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 483 | $739K |
| Dental(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 427 | $444K |
| Vision | STARMOUNT LIFE INSURANCE COMPANY | 591 | $73K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 677 | $90K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 86 | $33K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 119 | $17K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC. | 148 | $695K |
| Other(4 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 677 | $36K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 677 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.