| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS & INS. SERVICES | 1850 GATEWAY DR SUITE 700 SAN MATEO, CA 94404 | UNITEDHEALTHCARE INSURANCE COMPANY | $95K | $3K | $97K | 4.71% |
| ALLIANT INSURANCE SERVICES, INC.3 | PO BOX 8299 PASSADENA, CA 91109 | KAISER FOUNDATION HEALTH PLAN INC | $5K | — | $5K | 4.77% |
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS & INS. SERVICES | 1850 GATEWAY DR SUITE 600 SAN MATEO, CA 94404 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $10K | — | $10K | 10.00% |
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS & INS. SERVICES | 1850 GATEWAY DR SUITE 600 SAN MATEO, CA 94404 | MUTUAL OF OMAHA INSURANCE COMPANY | $3K | — | $3K | 10.00% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 701 B ST FLOOR 6 SAN DIEGO, CA 92101 | MUTUAL OF OMAHA INSURANCE COMPANY | — | $235 | $235 | 0.91% |
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS & INS. SERVICES | 1850 GATEWAY DR SUITE 700 SAN MATEO, CA 94404 | KAISER FOUNDATION HEALTH PLAN INC | $852 | — | $852 | 4.60% |
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS & INS. SERVICES | 1850 GATEWAY DR SUITE 600 SAN MATEO, CA 94404 | COMPANION LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 701 B ST FLOOR 6 SAN DIEGO, CA 92101 | COMPANION LIFE INSURANCE COMPANY | — | $156 | $156 | 0.89% |
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS & INS. SERVICES | 1850 GATEWAY DR SUITE 600 SAN MATEO, CA 94404 | MUTUAL OF OMAHA INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 701 B ST FLOOR 6 SAN DIEGO, CA 92101 | MUTUAL OF OMAHA INSURANCE COMPANY | — | $152 | $152 | 0.91% |
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS & INS. SERVICES | 1850 GATEWAY DR SUITE 600 SAN MATEO, CA 94404 | MUTUAL OF OMAHA INSURANCE COMPANY | $440 | — | $440 | 10.00% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 701 B ST FLOOR 6 SAN DIEGO, CA 92101 | MUTUAL OF OMAHA INSURANCE COMPANY | — | $39 | $39 | 0.89% |
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 | 141 | 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) | 141 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 251 | $2.2M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 135 | $105K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 135 | $105K |
| Life insurance(2 contracts, 2 carriers) | COMPANION LIFE INSURANCE COMPANY | 135 | $22K |
| Short-term disability | MUTUAL OF OMAHA INSURANCE COMPANY | 135 | $17K |
| Long-term disability | MUTUAL OF OMAHA INSURANCE COMPANY | 135 | $26K |
| Prescription drug(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC | 23 | $128K |
| Other | MUTUAL OF OMAHA INSURANCE COMPANY | 135 | $4K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 251 | — |
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.