| 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. | $28K | $1K | $29K | 4.54% |
| SEQUOIA BENEFITS & INS SVCS LLC3 | 1850 GATEWAY DRIVE, SUITE 600 SAN MATEO, CA 94404 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $58K | $22K | $80K | 16.34% |
| PACIFIC ADVISORS LLC3 Filed as: PACIFIC ADVISORS INC | 1550 W COLORADO BLVD PASADENA, CA 91105 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $68 | — | $68 | 0.01% |
| GREGORY S GOLUB3 | 1850 GATEWAY DRIVE, SUITE 600 SAN MATEO, CA 94404 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $9K | — | $9K | 5.21% |
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS LLC | 1850 GATEWAY DR, STE 600 SAN MATEO, CA 94404 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $12K | $1K | $13K | 11.20% |
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS LLC | 1850 GATEWAY DRIVE, SUITE 600 SAN MATEO, CA 94404 | ANTHEM LIFE INSURANCE COMPANY | $7K | $668 | $8K | 11.20% |
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS LLC | 1850 GATEWAY DRIVE, SUITE 600 SAN MATEO, CA 94404 | BLUE CROSS OF CALIFORNIA | $770 | $70 | $840 | 11.19% |
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS | 1850 GATEWAY DRIVE, SUITE 600 SAN MATEO, CA 94404 | FOUR EVER LIFE INS CO. | $456 | — | $456 | 15.01% |
| ANTHEM INSURANCE COMPANIES, INC.3 | 120 MONUMENT CIRCLE INDIANAPOLIS, IN 46204 | FOUR EVER LIFE INS CO. | — | $30 | $30 | 0.99% |
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 | 340 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 344 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 340 | $936K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 275 | $487K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 275 | $487K |
| Life insurance | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 307 | $115K |
| Short-term disability | ANTHEM LIFE INSURANCE COMPANY | 307 | $71K |
| Long-term disability | ANTHEM LIFE INSURANCE COMPANY | 307 | $71K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 86 | $817K |
| Other(2 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 307 | $123K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 340 | — |
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.