| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SEQUOIA BENEFITS & INS SVCS LLC3 | 1850 GATEWAY DRIVE, SUITE 700 SAN MATEO, CA 94404 | KAISER FOUNDATION HEALTH PLAN INC | $24K | $1 | $24K | 4.87% |
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE SERVICES | 2677 N MAIN ST STE 800 SANTA ANA, CA 92705 | KAISER FOUNDATION HEALTH PLAN INC | $6K | — | $6K | 1.19% |
| SEQUOIA BENEFITS & INS SVCS LLC3 | 1850 GATEWAY DRIVE, SUITE 700 SAN MATEO, CA 94404 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $502 | $3K | 13.70% |
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE SERVICES | 1600 W HILLSDALE BLVD STE 201 SAN MATEO, CA 94402 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | $238 | $1K | 5.74% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK SUITE A BEACHWOOD, OH 44122 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $517 | $517 | 2.29% |
| SEQUOIA BENEFITS & INS SVCS LLC3 | 1850 GATEWAY DRIVE, SUITE 700 SAN MATEO, CA 94404 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $484 | $3K | 13.15% |
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE SERVICES | 1600 W HILLSDALE BLVD STE 201 SAN MATEO, CA 94402 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $877 | $238 | $1K | 5.40% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK SUITE A BEACHWOOD, OH 44122 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $446 | $446 | 2.16% |
| SEQUOIA BENEFITS & INS SVCS LLC3 | 1850 GATEWAY DRIVE, SUITE 700 SAN MATEO, CA 94404 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | $226 | $1K | 12.94% |
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE SERVICES | 1600 W HILLSDALE BLVD STE 201 SAN MATEO, CA 94402 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $428 | $110 | $538 | 5.35% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK SUITE A BEACHWOOD, OH 44122 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $215 | $215 | 2.14% |
| SEQUOIA BENEFITS & INS SVCS LLC3 | 1850 GATEWAY DRIVE, SUITE 700 SAN MATEO, CA 94404 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $721 | $150 | $871 | 12.92% |
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE SERVICES | 1600 W HILLSDALE BLVD STE 201 SAN MATEO, CA 94402 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $287 | $73 | $360 | 5.34% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK SUITE A BEACHWOOD, OH 44122 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $144 | $144 | 2.14% |
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 | 128 | 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) | 128 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 76 | $491K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 142 | $23K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 132 | $10K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 132 | $21K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 76 | $491K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 132 | $7K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 142 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.