| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SEQUOIA BENEFITS & INS SVCS LLC3 | 1850 GATEWAY DR STE 700 SAN MATEO, CA 944044067 | KAISER FOUNDATION HEALTH PLAN, INC. | $5K | — | $5K | 4.50% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SVCS (GA) | 32110 AGOURA RD WESTLAKE VILLAGE, CA 913614026 | KAISER FOUNDATION HEALTH PLAN, INC. | $1K | — | $1K | 1.22% |
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS & INS LLC | 1850 GATEWAY DR STE 700 SAN MATEO, CA 94404 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $692 | $3K | 8.43% |
| AMWINS3 Filed as: AMWINS CONNECT INS SVCS LLC | 1600 W HILLSDALE BLVD SAN MATEO, CA 94402 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $963 | $467 | $1K | 4.60% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK BEACHWOOD, OH 44122 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $385 | $385 | 1.24% |
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS & INS LLC | 1850 GATEWAY DR STE 700 SAN MATEO, CA 94402 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $650 | $2K | 8.83% |
| AMWINS3 Filed as: AMWINS CONNECT INS SVCS LLC | 1600 W HILLSDALE BLVD SAN MATEO, CA 94402 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $761 | $359 | $1K | 4.55% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK BEACHWOOD, OH 44122 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $304 | $304 | 1.24% |
| SEQUOIA BENEFITS & INS SVCS LLC3 | 1850 GATEWAY DR STE 700 SAN MATEO, CA 94404 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $478 | $2K | 11.72% |
| AMWINS3 Filed as: AMWINS CONNECT INS SVCS LLC | 1600 W HILLSDALE BLVD SAN MATEO, CA 94402 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $532 | $332 | $864 | 4.59% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK BEACHWOOD, OH 44122 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $346 | $346 | 1.84% |
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS & INS LLC | 1850 GATEWAY DR STE 700 SAN MATEO, CA 94404 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $300 | $22 | $322 | 7.61% |
| AMWINS3 Filed as: AMWINS CONNECT INS SVCS LLC | 1600 W HILLSDALE BLVD SAN MATEO, CA 94402 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $150 | $43 | $193 | 4.56% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK BEACHWOOD, OH 44122 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $60 | $60 | 1.42% |
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 | 113 | 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) | 113 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 18 | $121K |
| Dental | HAWAII MEDICAL SERVICE ASSOCIATION | 0 | $6K |
| Vision | HAWAII MEDICAL SERVICE ASSOCIATION | 0 | $6K |
| Life insurance(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 159 | $25K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 115 | $31K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 115 | $25K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 18 | $121K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 163 | $4K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 163 | — |
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.