| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $75K | — | $75K | 3.90% |
| ADSH INVESTMENTS3 Filed as: ADSH INVESTMENTS II INC. | 24712 AVONDALE DRIVE LAGUNA HILLS, CA 92653 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $22K | — | $22K | 1.16% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 5664 PRAIRIE CREEK DRIVE CALEDONIA, MI 49316 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | — | $907 | $907 | 0.05% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUTE 1200 IRVINE, CA 92612 | KAISER FOUNDATION HEALTH PLAN INC. | $20K | — | $20K | 1.68% |
| PENSION & BENEFIT INSURANCE SERVICE3 | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | KAISER FOUNDATION HEALTH PLAN INC. | $4K | — | $4K | 0.32% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | BLUE CROSS OF CALIFORNIA | $22K | — | $22K | 3.90% |
| ADSH INVESTMENTS3 Filed as: ADSH INVESTMENTS II INC. | 24712 AVONDALE DRIVE LAGUNA HILLS, CA 92653 | BLUE CROSS OF CALIFORNIA | $7K | — | $7K | 1.16% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 5664 PRAIRIE CREEK DRIVE CALEDONIA, MA 49316 | BLUE CROSS OF CALIFORNIA | — | $273 | $273 | 0.05% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $4K | $5K | $10K | 3.86% |
| BENEFITS EXCHANGE ALLIANCE3 Filed as: BENEFITS EXCHANGE ALLIANCE, INC. | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $839 | — | $839 | 0.34% |
| PACIFIC ADVISORS LLC3 | 333 INDIAN HILL BLVD. CLAREMONT, CA 91711 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $371 | — | $371 | 0.15% |
| JOHN E. GREGORY3 | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $2K | $2K | 2.86% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $929 | — | $929 | 1.68% |
| ADSD INVESTMENTS I INC.3 | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $175 | — | $175 | 0.32% |
| JOHN E. GREGORY3 | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $1K | $1K | 2.94% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $769 | — | $769 | 1.64% |
| ADSD INVESTMENTS I INC.3 | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $169 | — | $169 | 0.36% |
| BENEFITS EXCHANGE ALLIANCE3 Filed as: BENEFITS EXCHANGE ALLIANCE, INC. | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $722 | — | $722 | 2.15% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | VISION SERVICE PLAN | $3K | — | $3K | 7.49% |
| BENEFITS EXCHANGE ALLIANCE3 Filed as: BENEFITS EXCHANGE ALLIANCE, INC. | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | VISION SERVICE PLAN | $821 | — | $821 | 2.46% |
| JOHN E. GREGORY3 | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $668 | $668 | 2.96% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $378 | — | $378 | 1.67% |
| ADSD INVESTMENTS I INC.3 | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $74 | — | $74 | 0.33% |
| BENEFITS EXCHANGE ALLIANCE3 Filed as: BENEFITS EXCHANGE ALLIANCE, INC. | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $205 | — | $205 | 1.40% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $153 | — | $153 | 1.05% |
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 | 255 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 256 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 5 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 198 | $3.7M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 209 | $247K |
| Vision | VISION SERVICE PLAN | 188 | $33K |
| Life insurance(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 255 | $78K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 255 | $47K |
| Prescription drug(5 contracts, 5 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 198 | $3.7M |
| Other | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 255 | $55K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 255 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.