| 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 | $242K | $5K | $247K | 5.46% |
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE SERVICES | 1600 W HILLSDALE BLVD STE 201 SAN MATEO, CA 94403 | BLUE CROSS OF CALIFORNIA | — | $90K | $90K | 1.99% |
| TRIAD FINANCIAL INSURANCE MARKETING3 | 18757 BURBANK BOULEVARD SUITE #303 TARZANA, CA 91356 | BLUE CROSS OF CALIFORNIA | $139 | — | $139 | 0.00% |
| 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. | $21K | $23 | $21K | 4.90% |
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE SERVICES | 2677 N MAIN ST STE 800 SANTA ANA, CA 92705 | KAISER FOUNDATION HEALTH PLAN INC. | $896 | — | $896 | 0.21% |
| SEQUOIA BENEFITS & INS SVCS LLC3 | 1850 GATEWAY DRIVE, SUITE 700 SAN MATEO, CA 94404 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $20K | $417 | $20K | 5.46% |
| 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 | — | $7K | $7K | 1.99% |
| TRIAD FINANCIAL INSURANCE MARKETING3 | 18757 BURBANK BOULEVARD SUITE #303 TARZANA, CA 91356 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $11 | — | $11 | 0.00% |
| SEQUOIA BENEFITS & INS SVCS LLC3 | 1850 GATEWAY DRIVE, SUITE 700 SAN MATEO, CA 94404 | ANTHEM LIFE INSURANCE COMPANY | $6K | — | $6K | 9.94% |
| AMWINS3 Filed as: AMWINS CONNECT INS SVCS LLC | 2677 N MAIN ST STE 800 SANTA ANA, CA 92705 | ANTHEM LIFE INSURANCE COMPANY | $1K | $119 | $1K | 2.37% |
| TRIAD FINANCIAL INSURANCE MARKETING3 | 18757 BURBANK BOULEVARD STE 303 TARZANA, CA 91356 | ANTHEM LIFE INSURANCE COMPANY | $1K | — | $1K | 1.73% |
| SEQUOIA BENEFITS & INS SVCS LLC3 | 1850 GATEWAY DRIVE, SUITE 700 SAN MATEO, CA 94404 | ANTHEM LIFE INSURANCE COMPANY | $6K | — | $6K | 9.90% |
| AMWINS3 Filed as: AMWINS CONNECT INS SVCS LLC | 2677 N MAIN ST STE 800 SANTA ANA, CA 92705 | ANTHEM LIFE INSURANCE COMPANY | $1K | $111 | $1K | 2.35% |
| TRIAD FINANCIAL INSURANCE MARKETING3 | 18757 BURBANK BOULEVARD STE 303 TARZANA, CA 91356 | ANTHEM LIFE INSURANCE COMPANY | $999 | — | $999 | 1.73% |
| SEQUOIA BENEFITS & INS SVCS LLC3 | 1850 GATEWAY DRIVE, SUITE 700 SAN MATEO, CA 94404 | ANTHEM LIFE INSURANCE COMPANY | $3K | — | $3K | 9.94% |
| AMWINS3 Filed as: AMWINS CONNECT INS SVCS LLC | 2677 N MAIN ST STE 800 SANTA ANA, CA 92705 | ANTHEM LIFE INSURANCE COMPANY | $750 | $69 | $819 | 2.37% |
| TRIAD FINANCIAL INSURANCE MARKETING3 | 18757 BURBANK BOULEVARD STE 303 TARZANA, CA 91356 | ANTHEM LIFE INSURANCE COMPANY | $600 | — | $600 | 1.73% |
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 | 195 | 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) | 204 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 367 | $5.0M |
| Dental | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 411 | $374K |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 411 | $374K |
| Life insurance | ANTHEM LIFE INSURANCE COMPANY | 252 | $58K |
| Short-term disability | ANTHEM LIFE INSURANCE COMPANY | 252 | $35K |
| Long-term disability | ANTHEM LIFE INSURANCE COMPANY | 252 | $60K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC. | 50 | $435K |
| Other | ANTHEM LIFE INSURANCE COMPANY | 252 | $58K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 411 | — |
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.