| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 5664 PRAIRIE CREEK DR SE CALEDONIA, MI 493168081 | KAISER FOUNDATION HEALTH PLAN INC | $207 | — | $207 | 0.01% |
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS LLC | 1850 GATEWAY DR STE 600 SAN MATEO, CA 94404 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $29K | $19K | $48K | 7.75% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 2055 WOODSIDE RD STE 290 REDWOOD CITY, CA 94061 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $861 | $3K | 0.49% |
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS LLC | 1850 GATEWAY DR STE 600 SAN MATEO, CA 94404 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $4K | $10K | 7.49% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 2055 WOODSIDE RD STE 290 REDWOOD CITY, CA 94061 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $805 | $322 | $1K | 0.87% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 9655 GRANITE RIDGE DRIVE STE 500 SAN DIEGO, CA 92123 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $1K | — | $1K | 4.11% |
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS LLC | 1850 GATEWAY DR STE 600 SAN MATEO, CA 94404 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $1K | — | $1K | 3.83% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 2055 WOODSIDE RD STE 290 REDWOOD CITY, CA 94061 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $424 | $170 | $594 | 7.01% |
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 | 897 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 897 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 247 | $1.5M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 2 | $36K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 943 | $748K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 0 | $8K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 943 | $618K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 247 | $1.4M |
| Other(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 943 | $784K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 943 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.