| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS AND INS SERVICE | 1850 GATEWAY DRIVE SUITE 700 SAN MATEO, CA 94404 | UNITEDHEALTHCARE INSURANCE COMPANY | — | $0 | $0 | 0.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | 3390 UNIVERSITY AVE SUITE 300 RIVERSIDE, CA 92501 | UNITEDHEALTHCARE INSURANCE COMPANY | -$15 | — | -$15 | -0.00% |
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS AND INS SERVICE | 1850 GATEWAY DRIVE SUITE 700 SAN MATEO, CA 94404 | UNITEDHEALTHCARE INSURANCE COMPANY | $4K | — | $4K | 12.65% |
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 | 38 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 38 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 49 | $525K |
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 49 | $525K |
| Vision | AMERITAS LIFE INSURANCE CORP. | 63 | $2K |
| Life insurance | UNITEDHEALTHCARE INSURANCE COMPANY | 157 | $30K |
| Short-term disability | UNITEDHEALTHCARE INSURANCE COMPANY | 157 | $30K |
| Long-term disability | UNITEDHEALTHCARE INSURANCE COMPANY | 157 | $30K |
| Other | UNITEDHEALTHCARE INSURANCE COMPANY | 157 | $30K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 157 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.