| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RELATION INSURANCE INC3 Filed as: RELATION INS. SERVICES OF CA, INC. | 1277 TREAT BOULEVARD, SUITE 400 WALNUT CREEK, CA 94597 | KAISER FOUNDATION HEALTH PLAN INC | $11K | $0 | $11K | 3.94% |
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS AND INS. SVS., LLC | 1850 GATEWAY DRIVE, SUITE 700 SAN MATEO, CA 94404 | KAISER FOUNDATION HEALTH PLAN INC | $6K | $0 | $6K | 2.20% |
| RELATION INSURANCE INC3 Filed as: RELATION INS. SERVICES OF CA, INC. | 1277 TREAT BOULEVARD, SUITE 400 WALNUT CREEK, CA 94597 | CALIFORNIA PHYSICIANS SERVICE | $796 | $0 | $796 | 2.45% |
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS AND INS. SVS., LLC | 1850 GATEWAY DRIVE, SUITE 600 SAN MATEO, CA 94404 | CALIFORNIA PHYSICIANS SERVICE | $755 | $0 | $755 | 2.32% |
| RELATION INSURANCE INC3 Filed as: RELATION INS. SERVICES OF CA, INC. | 1277 TREAT BOULEVARD, SUITE 400 WALNUT CREEK, CA 94597 | BLUE CROSS OF CALIFORNIA | $6K | $0 | $6K | 43.66% |
| AMWINS3 Filed as: AMWINS CONNECT INS. SERVICES LLC | 2677 NORTH MAIN STREET SANTA ANA, CA 92705 | BLUE CROSS OF CALIFORNIA | $0 | $6K | $6K | 41.28% |
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS AND INS. SVS., LLC | 1850 GATEWAY DRIVE, SUITE 700 SAN MATEO, CA 94404 | BLUE CROSS OF CALIFORNIA | $5K | $0 | $5K | 38.90% |
| RELATION INSURANCE INC3 Filed as: RELATION INS. SERVICES OF CA, INC. | 1277 TREAT BOULEVARD, SUITE 400 WALNUT CREEK, CA 94597 | BLUE SHIELD OF CALIFORNIA LIFE HEALTH INSURANCE COMPANY | $205 | $0 | $205 | 2.44% |
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS AND INS. SVS., LLC | 1850 GATEWAY DRIVE, SUITE 600 SAN MATEO, CA 94404 | BLUE SHIELD OF CALIFORNIA LIFE HEALTH INSURANCE COMPANY | $181 | $0 | $181 | 2.16% |
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 | 154 | 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) | 154 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 41 | $300K |
| Dental | CALIFORNIA PHYSICIANS SERVICE | 154 | $32K |
| Vision | CALIFORNIA PHYSICIANS SERVICE | 154 | $32K |
| Life insurance | BLUE SHIELD OF CALIFORNIA LIFE HEALTH INSURANCE COMPANY | 154 | $8K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 41 | $300K |
| Other | BLUE SHIELD OF CALIFORNIA LIFE HEALTH INSURANCE COMPANY | 154 | $8K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 154 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.