| 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 | KAISER FOUNDATION HEALTH PLAN INC. | — | $2K | $2K | 0.16% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS SVCS OF CA | 3697 MT. DIABLO BLVD. SUITE 100 LAFAYETTE, CA 94549 | VISION SERVICE PLAN | $3K | — | $3K | 2.14% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES | OF CALIFORNIA, INC. 3697 MT. DIABLO BLVD. SUITE 100 LAFAYETTE, CA 94549 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $5K | $5K | 3.60% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES | OF CALIFORNIA, INC. 3697 MT. DIABLO BLVD. SUITE 100 LAFAYETTE, CA 94549 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $3K | $3K | 3.69% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES | OF CALIFORNIA, INC. 3697 MT. DIABLO BLVD. SUITE 100 LAFAYETTE, CA 94549 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $3K | $3K | 7.64% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES | OF CALIFORNIA, INC. 3697 MT. DIABLO BLVD. SUITE 100 LAFAYETTE, CA 94549 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $1K | $1K | 3.97% |
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 | 748 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 748 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 207 | $1.2M |
| Dental | HAWAII MEDICAL SERVICE ASSOCIATION | 2 | $28K |
| Vision | VISION SERVICE PLAN | 712 | $163K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 739 | $145K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 746 | $85K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 748 | $42K |
| Other(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 739 | $43K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 748 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.