| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 5.00% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUTE 1200 IRVINE, CA 92612 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $11K | — | $11K | 14.91% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER H&B ADMINISTRATION LLC | PO BOX 850502 MINNEAPOLIS, MN 55485 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | — | $1K | 1.76% |
| AON CONSULTING INC3 Filed as: AON RISK INSURANCE SVCS WEST INC | 425 MARKET ST. SUITE 2800 SAN FRANCISCO, CA 94105 | NATIONAL UNION FIRE INS CO OF PITTSBURGH, PA | $4K | — | $4K | 20.00% |
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 | 1,017 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 33 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,050 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts) | DELTA DENTAL OF CALIFORNIA | 2,427 | $1.1M |
| Vision | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS COMPANY | 2,599 | $128K |
| Life insurance | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 1,133 | $809K |
| Long-term disability | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 1,133 | $286K |
| Other(6 contracts, 6 carriers) | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 2,722 | $1.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,722 | — |
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."
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.