| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SEQUOIA BENEFITS & INS SVCS LLC3 | 1850 GATEWAY DRIVE, SUITE 700 SAN MATEO, CA 94404 | KAISER FOUNDATION HEALTH PLAN INC | $9K | — | $9K | 1.99% |
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS AND INS SVCS LLC | 1850 GATEWAY DR, SUITE 700 SAN MATEO, CA 94404 | HARTFORD LIFE AND ACCIDENT | $19K | $274 | $19K | 7.61% |
| SEQUOIA BENEFITS & INS SVCS LLC3 | 1850 GATEWAY DR, SUITE 700 SAN MATEO, CA 94404 | DELTA DENTAL OF CALIFORNIA | $12K | — | $12K | 4.99% |
| SEQUOIA BENEFITS & INS SVCS LLC3 | 1850 GATEWAY DRIVE, SUITE 700 SAN MATEO, CA 94404 | KAISER FOUNDATION HEALTH PLAN INC | $2K | — | $2K | 1.99% |
| SEQUOIA BENEFITS & INS SVCS LLC3 | 1850 GATEWAY DRIVE, SUITE 600 SAN MATEO, CA 94404 | AMERITAS LIFE INSURANCE CORP | $4K | — | $4K | 10.00% |
| SEQUOIA BENEFITS & INS SVCS LLC3 | 1850 GATEWAY DRIVE, SUITE 700 SAN MATEO, CA 94404 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $702 | — | $702 | 10.00% |
| SEQUOIA BENEFITS & INS SVCS LLC3 | 1850 GATEWAY DRIVE, SUITE 700 SAN MATEO, CA 94404 | KAISER FOUNDATION HEALTH PLAN INC | $46 | — | $46 | 0.98% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| SEQUOIA BENEFITS LLC EIN 94-3397213 NONE | Insurance agents and brokers Service code 22 | — | $135K |
| CENTERSTONE INS & FINANCIAL EIN 95-4018229 NONE | Insurance services Service code 23 | — | $71K |
| CIGNA HEALTH AND LIFE INS EIN 59-1031071 NONE | Insurance services Service code 23 | — | $15K |
| CIGNA | Contract Administrator; Real estate brokerage; Named fiduciary; Participant communication; Direct payment from the plan; Other services; Float revenue; Claims processing; Non-monetary compensation Service code 12 | — | $0 |
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 | 146 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 148 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts) | KAISER FOUNDATION HEALTH PLAN INC | 64 | $555K |
| Dental | DELTA DENTAL OF CALIFORNIA | 421 | $239K |
| Vision | AMERITAS LIFE INSURANCE CORP | 131 | $37K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 279 | $256K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 279 | $256K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 279 | $256K |
| Prescription drug(4 contracts) | KAISER FOUNDATION HEALTH PLAN INC | 64 | $555K |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 279 | $263K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 421 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.