| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SEQUOIA BENEFITS & INS SVCS LLC3 | 1850 GATEWAY DR STE 700 SAN MATEO, CA 94404 | KAISER FOUNDATION HEALTH PLAN INC | $22K | — | $22K | 3.75% |
| SEQUOIA BENEFITS & INS SVCS LLC3 | 1850 GATEWAY DR STE 700 SAN MATEO, CA 94404 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $9K | $9K | $18K | 6.95% |
| SEQUOIA BENEFITS & INS SVCS LLC3 | 1850 GATEWAY DR STE 700 SAN MATEO, CA 94404 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $9K | $931 | $10K | 108.72% |
| SEQUOIA BENEFITS & INS SVCS LLC3 Filed as: SEQUOIA BENEFITS LLC | 1850 GATEWAY DR STE 700 SAN MATEO, CA 94404 | METLIFE LEGAL PLANS | $662 | — | $662 | 10.10% |
| SEQUOIA BENEFITS & INS SVCS LLC3 | 1850 GATEWAY DRIVE, SUITE 700 SAN MATEO, CA 94404 | METROPOLITAN GENERAL INSURANCE COMPANY | $141 | — | $141 | 7.63% |
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 | 151 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 45 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 196 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 41 | $596K |
| Dental(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 153 | $263K |
| Vision | VISION SERVICE PLAN | 134 | $37K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 266 | $75K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 266 | $48K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 266 | $57K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 41 | $587K |
| Other(4 contracts, 3 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 266 | $87K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 266 | — |
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.