| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWER WATSON INSURANCE SVCS | 300 S GRAND AVE STE 2000 LOS ANGELES, CA 90071 | BLUE CROSS OF CALIFORNIA | $75K | — | $75K | 3.66% |
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS & INS LLC | 1850 GATEWAY DR STE 700 SAN MATEO, CA 94404 | BLUE CROSS OF CALIFORNIA | $26K | — | $26K | 1.30% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SERVICES OF CA | 525 MARKET ST STE 3400 SAN FRANCISCO, CA 94105 | KAISER FOUNDATION HEALTH PLAN, INC. | $28K | — | $28K | 2.26% |
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS & INS LLC | 1850 GATEWAY DR STE 700 SAN MATEO, CA 94404 | KAISER FOUNDATION HEALTH PLAN, INC. | $6K | $4 | $6K | 0.48% |
| WILLIS TOWERS WATSON US LLC3 | LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | STANDARD INSURANCE COMPANY | — | $504 | $504 | 1.36% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWER WATSON INSURANCE SVCS | PO BOX 101162 PASADENA, CA 91189 | VISION SERVICE PLAN | $1K | — | $1K | 3.40% |
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS & INS LLC | 1850 GATEWAY DR STE 700 SAN MATEO, CA 94404 | VISION SERVICE PLAN | $817 | — | $817 | 2.28% |
| WILLIS TOWERS WATSON US LLC3 | LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | STANDARD INSURANCE COMPANY | — | $453 | $453 | 1.37% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWER WATSON | PO BOX 101162 PASADENA, CA 91189 | CLAREMONT BEHAVIORAL SERVICES, INC | $1K | — | $1K | 5.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWER WATSON INSURANCE SVCS | 300 S GRAND AVE STE 2000 LOS ANGELES, CA 90071 | DELTA DENTAL OF CALIFORNIA | $231 | — | $231 | 3.26% |
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS & INS LLC | 1850 GATEWAY DR STE 700 SAN MATEO, CA 94404 | DELTA DENTAL OF CALIFORNIA | $124 | — | $124 | 1.75% |
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 | 335 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 338 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 218 | $3.3M |
| Dental | DELTA DENTAL OF CALIFORNIA | 34 | $7K |
| Vision(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 282 | $2.1M |
| Life insurance | STANDARD INSURANCE COMPANY | 212 | $37K |
| Long-term disability | STANDARD INSURANCE COMPANY | 140 | $33K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 218 | $3.3M |
| Other(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 326 | $57K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 326 | — |
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."
No prospect flags tripped on this filing.