| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS AND INSURANCE SERV | 1850 GATEWAY DRIVE SUITE 700 SAN MATEO, CA 94404 | BLUE CROSS OF CALIFORNIA | $46K | $239 | $46K | 5.66% |
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS AND INSURANCE SERV | 1850 GATEWAY DRIVE SUITE 700 SAN MATEO, CA 94404 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | — | — | $0 | 0.00% |
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS AND INSURANCE SERV | 1850 GATEWAY DRIVE SUITE 700 SAN MATEO, CA 94404 | KAISER FOUNDATION HEALTH PLAN INC | $871 | $0 | $871 | 5.52% |
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE SERVICES | 2677 N MAIN ST STE 800 SANTA ANA, CA 92705 | KAISER FOUNDATION HEALTH PLAN INC | $251 | $0 | $251 | 1.59% |
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS AND INSURANCE SERV | 1850 GATEWAY DRIVE SUITE 700 SAN MATEO, CA 94404 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE CO. | $572 | $0 | $572 | 26.07% |
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 | 75 | 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) | 75 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 56 | $837K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 75 | $136K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 75 | $136K |
| Life insurance | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE CO. | 75 | $2K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 75 | $136K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 75 | $136K |
| Other | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE CO. | 75 | $2K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 75 | — |
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."
No prospect flags tripped on this filing.