| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA | PO BOX 101162 PASADENA, CA 91189 | KAISER FOUNDATION HEALTH PLAN INC | $29K | — | $29K | 2.81% |
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS, LLC | 1850 GATEWAY DR STE 700 SAN MATEO, CA 94404 | KAISER FOUNDATION HEALTH PLAN INC | $20K | — | $20K | 1.95% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | 525 MARKET STREET SUITE 3400 SAN FRANCISCO, CA 94105 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $13K | — | $13K | 2.92% |
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS LLC | 1850 GATEWAY DR STE 700 SAN MATEO, CA 94404 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $9K | — | $9K | 2.04% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON WEST(MT VIEW) | PO BOX 101162 PASADENA, CA 91189 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | — | $2K | $2K | 0.46% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SERVICES OF CA, INC | PO BOX 100003 PASADENA, CA 91189 | RELIASTAR LIFE INSURANCE COMPANY | $26K | — | $26K | 8.62% |
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS LLC | 1850 GATEWAY DR STE 700 SAN MATEO, CA 94404 | RELIASTAR LIFE INSURANCE COMPANY | $16K | — | $16K | 5.41% |
| IMPLICO COMMUNICATIONS, INC.3 Filed as: IMPLICO COMMUNICATIONS INC. | 2323 ROSS AVE STE 1700 DALLAS, TX 75201 | RELIASTAR LIFE INSURANCE COMPANY | — | $8K | $8K | 2.60% |
| POLSINELLI PC3 | 900 W 48TH PL STE 900 KANSAS CITY, MO 64112 | RELIASTAR LIFE INSURANCE COMPANY | — | $3K | $3K | 1.03% |
| ODA CREATIVE PARTNERS3 Filed as: ODA CREATIVE PARTNERS, LTD. | 212 N SANGAMON ST UNIT 4G CHICAGO, IL 60607 | RELIASTAR LIFE INSURANCE COMPANY | — | $450 | $450 | 0.15% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA, INC. | PO BOX 101162 PASADENA, CA 91189 | VISION SERVICE PLAN | $3K | — | $3K | 5.04% |
| SEQUOIA BENEFITS & INS SVCS LLC3 | 1850 GATEWAY DRIVE STE 600 SAN MATEO, CA 94404 | VISION SERVICE PLAN | $3K | — | $3K | 4.09% |
| WILLIS TOWERS WATSON US LLC3 | PO BOX 28852 NEW YORK, NY 10087 | VISION SERVICE PLAN | $546 | — | $546 | 0.87% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA | PO BOX 101162 PASADENA, CA 91189 | KAISER FOUNDATION HEALTH PLAN INC | $2K | — | $2K | 2.92% |
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS, LLC | 1850 GATEWAY DR STE 700 SAN MATEO, CA 94404 | KAISER FOUNDATION HEALTH PLAN INC | $1K | — | $1K | 2.08% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | 525 MARKET STREET SUITE 3400 SAN FRANCISCO, CA 94105 | NATIONAL UNION FIRE INS. CO. OF PITTSBURGH, PA | $620 | — | $620 | 15.00% |
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 | 412 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 12 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 424 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC | 157 | $1.1M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 379 | $430K |
| Vision | VISION SERVICE PLAN | 347 | $63K |
| Life insurance | RELIASTAR LIFE INSURANCE COMPANY | 500 | $302K |
| Short-term disability | RELIASTAR LIFE INSURANCE COMPANY | 500 | $302K |
| Long-term disability | RELIASTAR LIFE INSURANCE COMPANY | 500 | $302K |
| Prescription drug(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC | 157 | $1.1M |
| Other(3 contracts, 3 carriers) | RELIASTAR LIFE INSURANCE COMPANY | 500 | $319K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 500 | — |
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.