| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SEQUOIA BENEFITS & INS SVCS LLC3 | 1850 GATEWAY DRIVE STE 700 SAN MATEO, CA 94404 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $946 | — | $946 | 8.22% |
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE SERVICES | 1600 W HILLSDALE BLVD STE 201 SAN MATEO, CA 94402 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $473 | — | $473 | 4.11% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN ROAD SOLON, OH 44139 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $189 | — | $189 | 1.64% |
| SEQUOIA BENEFITS & INS SVCS LLC3 | 1850 GATEWAY DRIVE STE 700 SAN MATEO, CA 94404 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $639 | — | $639 | 8.36% |
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE SERVICES | 1600 W HILLSDALE BLVD STE 201 SAN MATEO, CA 94402 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $319 | — | $319 | 4.17% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN ROAD SOLON, OH 44139 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $128 | — | $128 | 1.67% |
| SEQUOIA BENEFITS & INS SVCS LLC3 | 1850 GATEWAY DRIVE STE 700 SAN MATEO, CA 94404 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $497 | — | $497 | 8.23% |
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE SERVICES | 1600 W HILLSDALE BLVD STE 201 SAN MATEO, CA 94402 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $248 | — | $248 | 4.10% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN ROAD SOLON, OH 44139 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $99 | — | $99 | 1.64% |
| SEQUOIA BENEFITS & INS SVCS LLC3 | 1850 GATEWAY DRIVE STE 700 SAN MATEO, CA 94404 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $129 | — | $129 | 8.23% |
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE SERVICES | 1600 W HILLSDALE BLVD STE 201 SAN MATEO, CA 94402 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $65 | — | $65 | 4.15% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN ROAD SOLON, OH 44139 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $26 | — | $26 | 1.66% |
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 | 223 | 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) | 223 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 14 | $15K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 250 | $8K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 224 | $6K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 224 | $12K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 14 | $15K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 224 | $2K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 250 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.