| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRIVNE, CA 92612 | BLUE CROSS OF CALIFORNIA | $213K | $16K | $229K | 3.72% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $20K | $9K | $29K | 39.82% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRIVNE, CA 92612 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $2K | $143 | $2K | 3.73% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $10K | $2K | $12K | 23.00% |
| PLANSOURCE BENEFIT ADMINISTRATION3 | 101 S GARLAND AVENUE, SUITE 203 ORLANDO, FL 32801 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $503 | $503 | 1.00% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $12K | $4K | $16K | 36.18% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $8K | $1K | $10K | 23.00% |
| PLANSOURCE BENEFIT ADMINISTRATION3 | 101 S GARLAND AVENUE, SUITE 203 ORLANDO, FL 32801 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $415 | $415 | 1.00% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $2K | — | $2K | 7.99% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | $2K | $5K | 39.96% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $1K | $4K | 45.30% |
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 | 564 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 573 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 1,089 | $6.2M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 106 | $19K |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 1,091 | $55K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 733 | $74K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 85 | $9K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 547 | $44K |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 1,089 | $6.2M |
| Other(4 contracts, 2 carriers) | MODERN LIFE INC. | 736 | $206K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,091 | — |
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.