| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS & INSURANCE SVCS | 1850 GATEWAY DRIVE, SUITE 700 SAN MATEO, CA 94404 | BLUE CROSS OF CALIFORNIA | $214K | $3K | $217K | 5.45% |
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE SERVICES | 1600 W HILLSDALE BLVD STE 201 SAN MATEO, CA 94403 | BLUE CROSS OF CALIFORNIA | — | $79K | $79K | 1.99% |
| TRIAD FINANCIAL INSURANCE MARK3 Filed as: TRIAD FINANCIAL INSURANCE MARKETING | 18757 BURBANK BOULEVARD SUITE #303 TARZANA, CA 91356 | BLUE CROSS OF CALIFORNIA | $2K | $3K | $5K | 0.13% |
| SEQUOIA BENEFITS & INS SVCS LLC3 | 1850 GATEWAY DRIVE, SUITE 700 SAN MATEO, CA 94404 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $21K | $312 | $21K | 5.45% |
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE SERVICES | 1600 W HILLSDALE BLVD STE 201 SAN MATEO, CA 94403 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | — | $8K | $8K | 1.99% |
| TRIAD FINANCIAL INSURANCE MARK3 Filed as: TRIAD FINANCIAL INSURANCE MARKETING | 18757 BURBANK BOULEVARD SUITE #303 TARZANA, CA 91356 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $192 | $305 | $497 | 0.13% |
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS & INSURANCE SVCS | 1850 GATEWAY DRIVE, SUITE 700 SAN MATEO, CA 94404 | KAISER FOUNDATION HEALTH PLAN INC. | $17K | — | $17K | 4.94% |
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE SERVICES | 2677 N MAIN ST STE 800 SANTA ANA, CA 92705 | KAISER FOUNDATION HEALTH PLAN INC. | $303 | — | $303 | 0.09% |
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 | 218 | 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) | 220 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 402 | $4.4M |
| Dental | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 475 | $384K |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 475 | $384K |
| Life insurance | ANTHEM LIFE INSURANCE COMPANY | 264 | $27K |
| Short-term disability | ANTHEM LIFE INSURANCE COMPANY | 264 | $27K |
| Long-term disability | ANTHEM LIFE INSURANCE COMPANY | 264 | $27K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC. | 39 | $338K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 475 | — |
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.