| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SEQUOIA BENEFITS & INS SVCS LLC3 | 1850 GATEWAY DR STE 600 SAN MATEO, CA 94404 | CALIFORNIA PHYSICIANS' SERVICE | $220 | $179K | $179K | 4.17% |
| SEQUOIA BENEFITS & INS SVCS LLC3 | 1850 GATEWAY DR STE 700 SAN MATEO, CA 94404 | KAISER FOUNDATION HEALTH PLAN INC. | $38K | $5 | $38K | 3.67% |
| SEQUOIA BENEFITS & INS SVCS LLC3 | 1850 GATEWAY DR STE 600 SAN MATEO, CA 94404 | DELTA DENTAL OF CALIFORNIA | $27K | — | $27K | 6.00% |
| SEQUOIA BENEFITS & INS SVCS LLC3 | 1850 GATEWAY DR STE 600 SAN MATEO, CA 94404 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $17K | — | $17K | 7.66% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS LLC | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $798 | — | $798 | 0.37% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $62 | $62 | 0.03% |
| SEQUOIA BENEFITS & INS SVCS LLC3 | 1850 GATEWAY DR STE 600 SAN MATEO, CA 94404 | VISION SERVICE PLAN | $2K | — | $2K | 4.42% |
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 | 456 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 458 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 643 | $5.3M |
| Dental | DELTA DENTAL OF CALIFORNIA | 858 | $452K |
| Vision | VISION SERVICE PLAN | 365 | $52K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 576 | $216K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 576 | $216K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 643 | $5.3M |
| Other(3 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 576 | $282K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 858 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.