| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WOODRUFF-SAWYER & CO3 Filed as: WOODRUFF SAWYER AND COMPANY | 50 CALIFORNIA STREET, FL. 12 SAN FRANCISCO, CA 94111 | KAISER FOUNDATION HEALTH PLAN INC. | $84K | $4K | $89K | 2.09% |
| WOODRUFF-SAWYER & CO3 Filed as: WOODRUFF SAWYER AND COMPANY | 50 CALIFORNIA STREET, FL. 12 SAN FRANCISCO, CA 94111 | KAISER FOUNDATION HEALTH PLAN INC. | $12K | $2K | $14K | 1.06% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK INC. | EMPLOYEE BENEFITS PRACTICE 200 LIBERTY STREET NEW YORK, NY 10281 | HARTFORD LIFE INSURANCE CO. | $33K | — | $33K | 10.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SVCS OF CA | 18101 VON KARMAN AVE, STE 600 IRVINE, CA 92612 | HARTFORD LIFE INSURANCE CO. | — | $10K | $10K | 3.16% |
| WOODRUFF-SAWYER & CO3 Filed as: WOODRUFF SAWYER AND COMPANY | 50 CALIFORNIA STREET, FL. 12 SAN FRANCISCO, CA 94111 | KAISER FOUNDATION HEALTH PLAN INC. | $587 | — | $587 | 0.86% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK INC. | ONE WORLD FINANCIAL CENTER 200 LIBERTY STREET, 7TH FL NEW YORK, NY 10281 | HARTFORD LIFE AND ACCIDENT | $1K | — | $1K | 5.00% |
| WOODRUFF-SAWYER & CO3 Filed as: WOODRUFF-SAWYER & COMPANY | 50 CALIFORNIA STREET, 12TH FL. SAN FRANCISCO, CA 94111 | DELTA DENTAL OF CALIFORNIA | $2K | — | $2K | 9.18% |
| WOODRUFF-SAWYER & CO3 Filed as: WOODRUFF-SAWYER AND CO. | 50 CALIFORNIA ST, FL. 12 SAN FRANCISCO, CA 941114646 | VISION SERVICE PLAN | $450 | — | $450 | 10.01% |
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 | 427 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 413 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 840 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(6 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 561 | $7.5M |
| Dental(2 contracts) | DELTA DENTAL OF CALIFORNIA | 610 | $401K |
| Vision(2 contracts) | VISION SERVICE PLAN | 25 | $9K |
| Life insurance | HARTFORD LIFE INSURANCE CO. | 890 | $326K |
| Long-term disability | HARTFORD LIFE INSURANCE CO. | 890 | $326K |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE INSURANCE CO. | 890 | $349K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 890 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.