Form 5500 · Employee benefit plan · REDWOOD CITY, CA
EVERNOTE CORPORATION
The filing calls this plan EVERNOTE CORPORATION HEALTH AND WELFARE PLAN.
EVERNOTE CORPORATION of REDWOOD CITY, CA is a 235-participant professional services employer whose group benefits are disclosed in its annual Form 5500 filing. Its broker of record is SEQUOIA BENEFITS & INS SVCS LLC. Coverage is written through UNITEDHEALTHCARE INSURANCE COMPANY and 3 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 20-1897663 · plan 501 · plan year 2023, filed Jul 15, 2024
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How this plan is funded
Fully insured as reported
The filing reports medical coverage through an insurance contract on Schedule A, and no money paid for benefits by the plan itself.
Benefits declared on this filing
Life: LIFE INSURANCE COMPANY OF NORTH AMERICA covers 18 of 235 participants (7.7%) on Schedule A.
Disability: the largest of the 2 insured disability contracts, with LIFE INSURANCE COMPANY OF NORTH AMERICA, covers 16 of 235 participants (6.8%) on Schedule A.
One contract on this filing does not say which benefits it covers, so a line above may be insured by it.
Also declared: death benefits, other welfare.
Declared benefits are the plan’s own line 8b codes on Form 5500. “Not on Schedule A” means no insured contract for that line appears on this filing. That usually means the benefit is self-funded, or it sits under a different plan number.
Where a line has more than one insured contract, the carrier and the covered figure are the largest contract's by premium. The contracts are not added up: a pharmacy carve-out and the medical carrier beside it cover the same people.
Persons covered is the count the carrier filed for that policy at the end of its policy year, and it can include dependents. Participants is the plan's own count at the start of its plan year. The two count different people, so a covered figure can be larger.
Plan brief
Schedule A lists 7 insured contracts covering health, vision, life and disability; the largest, with UNITEDHEALTHCARE INSURANCE COMPANY, covers 176 people.
The filing declares health, vision, life, disability and dental. Dental appears with no insured contract on Schedule A. That coverage may be self-funded, placed with a carrier that is not on this filing, or written on the contract here that does not say what it covers.
Reported premium across the insured contracts is $2,841,350, with $140,569 in disclosed broker commissions — about 4.9% of premium.
The most recent policy period ended in December, and the plan year ends December 31. Group contracts typically renew on that annual cycle.
SEQUOIA BENEFITS & INS SVCS LLC is the broker of record on all 7 contracts.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| UNITEDHEALTHCARE INSURANCE COMPANY | Health | 176 | Jan 1, 2024 | $2,466,919 | $118,803 |
| KAISER FOUNDATION HEALTH PLAN, INC. | Health | 38 | Jan 1, 2024 | $274,936 | $13,874 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA | Life | 18 | Jan 1, 2024 | $24,662 | $2,398 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA | Disability | 16 | Jan 1, 2024 | $20,051 | $1,943 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA | Disability | 16 | Jan 1, 2024 | $13,908 | $1,348 |
| VISION SERVICE PLAN | Vision | 85 | Jan 1, 2024 | $32,009 | $1,343 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA | — | 17 | Jan 1, 2024 | $8,865 | $860 |
Covered = persons covered at policy year end, as filed on Schedule A for that policy — often certificates or one class, not the whole plan. Premium = the filing’s own premium/charges figure; “—” means not credibly reported.
Administrator and service providers
The plan administrator is from line 3a of the main form. We publish company names only.
Other plans filed by this employer
How this plan compares
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