| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS & INS. SERVICES | 1850 GATEWAY DR SUITE 600 SAN MATEO, CA 94404 | CALIFORNIA PHYSICIANS SERVICE | — | $116K | $116K | 5.27% |
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS & INS SERVICES LLC | 1850 GATEWAY DR SUITE 700 SAN MATEO, CA 94404 | KAISER FOUNDATION HEALTH PLAN INC | $14K | $335 | $14K | 5.04% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN INSURANCE ADMIN, INC. | 721 S PARKER ST STE 300 ORANGE, CA 92868 | KAISER FOUNDATION HEALTH PLAN INC | $5K | — | $5K | 1.57% |
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS & INS. SERVICES | 1850 GATEWAY DR SUITE 700 SAN MATEO, CA 94404 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $22K | $1K | $23K | 10.48% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INSURANCE AND FIN. SVCS | 12404 PARK CENTRAL DRIVE SUITE 400S DALLAS, TX 75251 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | — | $10K | $10K | 4.55% |
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS & INS. SERVICES | 1850 GATEWAY DR SUITE 700 SAN MATEO, CA 94404 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | — | $4K | 10.00% |
| NATIONAL BENEFIT CENTER3 Filed as: NATIONAL BENEFIT CENTER LLC | 23825 COMMERCE PARK SUITE A BEACHWOOD, OH 44122 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $791 | $791 | 2.00% |
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS & INS. SERVICES | 1850 GATEWAY DR SUITE 700 SAN MATEO, CA 94404 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 8.21% |
| NATIONAL BENEFIT CENTER3 Filed as: NATIONAL BENEFIT CENTER LLC | 23825 COMMERCE PARK SUITE A BEACHWOOD, OH 44122 | LIFE INSURANCE COMPANY OF NORTH AMERICA | -$47 | — | -$47 | -0.24% |
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS & INS. SERVICES | 1850 GATEWAY DR SUITE 700 SAN MATEO, CA 94404 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $505 | — | $505 | 9.54% |
| NATIONAL BENEFIT CENTER3 Filed as: NATIONAL BENEFIT CENTER LLC | 23825 COMMERCE PARK SUITE A BEACHWOOD, OH 44122 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $101 | $101 | 1.91% |
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 | 204 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 205 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 369 | $2.5M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 193 | $222K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 193 | $222K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 201 | $20K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 201 | $40K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 369 | $2.5M |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 201 | $5K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 369 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.