| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS LLC | 1850 GATEWAY DRIVE, SUITE 600 SAN MATEO, CA 94404 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $13K | — | $13K | 9.93% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS (NJ) | 4851 LBJ FWY SUITE 100 DALLAS, TX 75244 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | — | $5K | $5K | 3.55% |
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS, LLC | 1850 GATEWAY DRIVE, SUITE 600 SAN MATEO, CA 94404 | KAISER FOUNDATION HEALTH PLAN INC | $3K | — | $3K | 5.00% |
| SEQUOIA BENEFITS & INS SVCS LLC3 | 1850 GATEWAY DR, STE 600 SAN MATEO, CA 94404 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $723 | $210 | $933 | 12.91% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN ROAD SOLON, OH 44139 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $289 | $289 | 4.00% |
| SEQUOIA BENEFITS & INS SVCS LLC3 | 1850 GATEWAY DRIVE, SUITE 600 SAN MATEO, CA 94404 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $497 | $250 | $747 | 15.04% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN ROAD SOLON, OH 44139 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $199 | $199 | 4.01% |
| SEQUOIA BENEFITS & INS SVCS LLC3 | 1850 GATEWAY DR, STE 600 SAN MATEO, CA 94404 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $282 | $88 | $370 | 13.13% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN ROAD SOLON, OH 44139 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $113 | $113 | 4.01% |
| SEQUOIA BENEFITS & INS SVCS LLC3 | 1850 GATEWAY DRIVE, SUITE 600 SAN MATEO, CA 94404 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $113 | $80 | $193 | 17.02% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN ROAD SOLON, OH 44139 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $45 | $45 | 3.97% |
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 | 118 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 120 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 16 | $51K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 119 | $135K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 119 | $135K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 118 | $5K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 23 | $3K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 29 | $7K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 16 | $51K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 124 | $1K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 124 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.