| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS LLC | 1850 GATEWAY DRIVE, SUITE 700 SAN MATEO, CA 94404 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $147K | $3K | $150K | 4.59% |
| SEQUOIA BENEFITS & INS SVCS LLC3 | 1850 GATEWAY DR STE 700 SAN MATEO, CA 94404 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $367 | $4K | 12.22% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK SUITE A BEACHWOOD, OH 44122 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $662 | $662 | 2.20% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $350 | $350 | 1.16% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 21ST FL ARLINGTON HEIGHTS, IL 60006 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $236 | $3K | 11.01% |
| SEQUOIA BENEFITS & INS SVCS LLC3 | 1850 GATEWAY DRIVE, SUITE 700 SAN MATEO, CA 94404 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $770 | $80 | $850 | 6.63% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $512 | $77 | $589 | 4.60% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK SUITE A BEACHWOOD, OH 44122 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $154 | $154 | 1.20% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $1K | — | $1K | 25.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $1K | — | $1K | 25.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $1K | — | $1K | 25.00% |
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 | 376 | 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) | 379 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 233 | $3.3M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 233 | $3.3M |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 233 | $3.3M |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 433 | $30K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 391 | $23K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 233 | $3.3M |
| Other(5 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 433 | $53K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 433 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.