| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SEQUOIA BENEFITS & INS SVCS LLC3 | 1850 GATEWAY DRIVE, SUITE 700 SAN MATEO, CA 94404 | BLUE CROSS OF CALIFORNIA | $27K | $2 | $27K | 3.24% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INSURANCE AND FIN. SVCS | 12404 PARK CENTRAL DR SUITE #400S DALLAS, TX 75251 | BLUE CROSS OF CALIFORNIA | — | $16K | $16K | 1.92% |
| SEQUOIA BENEFITS & INS SVCS LLC3 | 1850 GATEWAY DRIVE, SUITE 700 SAN MATEO, CA 94404 | PRINCIPAL LIFE INSURANCE COMPANY | $8K | — | $8K | 8.63% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INSURANCE & FIN. SVCS. | 12404 PARK CENTRAL DR SUITE #400S DALLAS, TX 75251 | PRINCIPAL LIFE INSURANCE COMPANY | — | $4K | $4K | 4.31% |
| SEQUOIA BENEFITS & INS SVCS LLC3 | 1850 GATEWAY DRIVE, SUITE 700 SAN MATEO, CA 94404 | KAISER FOUNDATION HEALTH PLAN, INC. | $1K | — | $1K | 5.22% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INSURANCE & FIN. SVCS. | 12404 PARK CENTRAL DR SUITE #400S DALLAS, TX 75251 | KAISER FOUNDATION HEALTH PLAN, INC. | $360 | — | $360 | 1.30% |
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 | 150 | 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) | 150 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 194 | $849K |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 247 | $97K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 247 | $97K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 247 | $97K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 247 | $97K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 194 | $849K |
| Other | PRINCIPAL LIFE INSURANCE COMPANY | 247 | $97K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 247 | — |
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.