| 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. | $95K | $5K | $100K | 1.82% |
| WOODRUFF-SAWYER & CO3 Filed as: WOODRUFF SAWYER AND CO. | 50 CALIFORNIA ST, FLOOR 12 SAN FRANCISCO, CA 94111 | BLUE CROSS OF CALIFORNIA | $18K | — | $18K | 1.00% |
| WOODRUFF-SAWYER & CO3 Filed as: WOODRUFF SAWYER AND COMPANY | 50 CALIFORNIA STREET, FL. 12 SAN FRANCISCO, CA 94111 | KAISER FOUNDATION HEALTH PLAN INC. | $15K | $3K | $17K | 1.04% |
| 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 INSURANCE CO. | $10K | — | $10K | 10.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF NEW YORK INC. | 200 LIBERTY ST NEW YORK, NY 10281 | PRINCIPAL LIFE INSURANCE COMPANY | $5K | — | $5K | 10.00% |
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 | 306 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 461 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 767 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 581 | $9.0M |
| Dental(2 contracts) | DELTA DENTAL OF CALIFORNIA | 625 | $423K |
| Vision(2 contracts) | VISION SERVICE PLAN | 27 | $12K |
| Life insurance(2 contracts, 2 carriers) | HARTFORD LIFE INSURANCE CO. | 813 | $151K |
| Long-term disability | HARTFORD LIFE INSURANCE CO. | 0 | $101K |
| Other | HARTFORD LIFE INSURANCE CO. | 0 | $101K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 813 | — |
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.