| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS LLC | 1850 GATEWAY DRIVE, SUITE 700 SAN MATEO, CA 94404 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $10K | — | $10K | 9.92% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS AGENCY & FIN SVCS | 1133 WESTCHESTER AVENUE SUITE 229 WHITE PLAINS, NC 10604 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | — | $4K | $4K | 4.27% |
| SEQUOIA BENEFITS & INS SVCS LLC3 | 1850 GATEWAY DRIVE, SUITE 700 SAN MATEO, CA 94404 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | $899 | $2K | 18.75% |
| SEQUOIA BENEFITS & INS SVCS LLC3 | 1850 GATEWAY DRIVE, SUITE 700 SAN MATEO, CA 94404 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $817 | $647 | $1K | 17.91% |
| SEQUOIA BENEFITS & INS SVCS LLC3 | 1850 GATEWAY DRIVE, SUITE 700 SAN MATEO, CA 94404 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $786 | $592 | $1K | 17.54% |
| SEQUOIA BENEFITS & INS SVCS LLC3 | 1850 GATEWAY DRIVE, SUITE 700 SAN MATEO, CA 94404 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $305 | $201 | $506 | 16.57% |
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 | 31 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 34 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 65 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC. | 8 | $85K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 70 | $103K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 70 | $103K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 37 | $10K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 13 | $8K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 13 | $8K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC. | 8 | $85K |
| Other(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 70 | $106K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 70 | — |
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.
Final-filing indicator set. Plan is winding down; don't waste sales effort here.