| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS, LLC | 1850 GATEWAY DRIVE, SUITE 600 SAN MATEO, CA 94404 | KAISER FOUNDATION HEALTH PLAN INC. | $21K | $2K | $23K | 5.95% |
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS, LLC | 1850 GATEWAY DRIVE, SUITE 600 SAN MATEO, CA 94404 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $17K | $7K | $24K | 13.94% |
| PACIFIC ADVISORS LLC3 Filed as: PACIFIC ADVISORS INC | 333 N INDIAN HILL BLVD CLAREMONT, CA 91711 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $321 | — | $321 | 0.18% |
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS, LLC | 1850 GATEWAY DRIVE, SUITE 600 SAN MATEO, CA 94404 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $13K | $5K | $18K | 11.93% |
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS, LLC | 1850 GATEWAY DRIVE, SUITE 600 SAN MATEO, CA 94404 | ANTHEM LIFE INSURANCE COMPANY | $4K | $2K | $6K | 11.93% |
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS, LLC | 1850 GATEWAY DRIVE, SUITE 600 SAN MATEO, CA 94404 | BLUE CROSS OF CALIFORNIA | $717 | $258 | $975 | 11.93% |
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS LLC | 1850 GATEWAY DRIVE, SUITE 600 SAN MATEO, CA 94404 | FOUR EVER LIFE INSURANCE COMPANY | $298 | — | $298 | 15.01% |
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 | 148 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 149 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 148 | $395K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 143 | $174K |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 148 | $152K |
| Life insurance | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 148 | $152K |
| Short-term disability | ANTHEM LIFE INSURANCE COMPANY | 148 | $50K |
| Long-term disability | ANTHEM LIFE INSURANCE COMPANY | 148 | $50K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC. | 94 | $393K |
| Other(2 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 148 | $160K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 148 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.