| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SEQUOIA BENEFITS & INS SVCS LLC3 | 1850 GATEWAY DRIVE, SUITE 700 SAN MATEO, CA 94404 | ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. | $58K | $3K | $61K | 5.23% |
| SEQUOIA BENEFITS & INS SVCS LLC3 | 1850 GATEWAY DRIVE, SUITE 700 SAN MATEO, CA 94404 | KAISER FOUNDATION HEALTH PLAN INC. | $4K | $91 | $4K | 7.17% |
| SEQUOIA BENEFITS & INS SVCS LLC3 | 1850 GATEWAY DRIVE, SUITE 600 SAN MATEO, CA 94404 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | — | $5K | 15.00% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK SUITE A BEACHWOOD, OH 44122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $884 | $884 | 2.67% |
| SEQUOIA BENEFITS & INS SVCS LLC3 | 1850 GATEWAY DRIVE, SUITE 600 SAN MATEO, CA 94404 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 15.00% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK SUITE A BEACHWOOD, OH 44122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $575 | $575 | 2.68% |
| SEQUOIA BENEFITS & INS SVCS LLC3 | 1850 GATEWAY DRIVE, SUITE 600 SAN MATEO, CA 94404 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK SUITE A BEACHWOOD, OH 44122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $417 | $417 | 2.68% |
| SEQUOIA BENEFITS & INS SVCS LLC3 | 1850 GATEWAY DRIVE, SUITE 600 SAN MATEO, CA 94404 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $611 | — | $611 | 15.00% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK SUITE A BEACHWOOD, OH 44122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $152 | $152 | 3.73% |
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)(2 contracts, 2 carriers) | ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. | 188 | $1.2M |
| Dental | ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. | 188 | $1.2M |
| Vision | ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. | 188 | $1.2M |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 133 | $37K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 133 | $16K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 133 | $21K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC. | 9 | $52K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 133 | $37K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 188 | — |
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.