| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SVCS NATIONAL INC | 959 SKYWAY ROAD 2ND FLOOR SAN CARLOS, CA 94070 | BLUE CROSS OF CALIFORNIA | $91K | — | $91K | 2.98% |
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS LLC | 499 SEAPORT COURT, #300 REDWOOD CITY, CA 94063 | BLUE CROSS OF CALIFORNIA | $56K | — | $56K | 1.83% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SVCS NATIONAL INC | 213 SOUTH JEFFERSON STEET SOUTHWEST ROANOKE, VA 24011 | BLUE CROSS OF CALIFORNIA | $1K | $15K | $16K | 0.53% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SVCS NATIONAL INC | 21250 HAWTHORNE BL #600 TORRANCE, CA 90503 | BLUE CROSS OF CALIFORNIA | — | $3K | $3K | 0.09% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SVCS NATIONAL INC | PO BOX 203373 DALLAS, TX 75320 | KAISER FOUNDATION HEALTH PLAN INC | $50K | — | $50K | 3.00% |
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS LLC | 1850 GATEWAY DRIVE, SUITE 600 SAN MATEO, CA 94404 | KAISER FOUNDATION HEALTH PLAN INC | $33K | — | $33K | 1.98% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SVCS NATIONAL INC | 959 SKYWAY ROAD 2ND FLOOR SAN CARLOS, CA 94070 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $18K | — | $18K | 2.98% |
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS LLC | 499 SEAPORT COURT #300 REDWOOD CITY, CA 94063 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $11K | — | $11K | 1.83% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SVCS NATIONAL INC | 213 SOUTH JEFFERSON STREET SOUTHWEST ROANOKE, VA 24011 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $209 | $3K | $3K | 0.53% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SVCS NATIONAL INC | 21250 HAWTHORNE BL #600 TORRANCE, CA 90503 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | — | $535 | $535 | 0.09% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SVCS NATIONAL INC | PO BOX 39000 SAN FRANCISCO, CA 94139 | VISION SERVICE PLAN | $2K | — | $2K | 2.25% |
| SEQUOIA BENEFITS & INS SVCS LLC3 | 1850 GATEWAY DRIVE, SUITE 600 SAN MATEO, CA 94404 | VISION SERVICE PLAN | $554 | — | $554 | 0.75% |
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 | 379 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 388 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 476 | $4.7M |
| Dental | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 802 | $599K |
| Vision | VISION SERVICE PLAN | 366 | $73K |
| Life insurance | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 802 | $599K |
| Short-term disability | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 802 | $599K |
| Long-term disability | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 802 | $599K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 476 | $4.7M |
| Other | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 802 | $599K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 802 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.