| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BB&H BENEFIT DESIGNS3 | 109 EAST VICTORIA SANTA BARBARA, CA 93101 | CIGNA HEALTHCARE OF CALIFORNIA | $255K | — | $255K | 2.00% |
| BB&H BENEFIT DESIGNS3 | 109 EAST VICTORIA STREET SANTA BARBARA, CA 93101 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFLIATES | $75K | $14K | $89K | 3.18% |
| BB&H BENEFIT DESIGNS3 | 109 EAST VICTORIA STREET SANTA BARBARA, CA 93101 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $68K | — | $68K | 19.16% |
| EOI SERVICE COMPANY INC3 Filed as: EOI SERVICE COMPANY | 1820 EAST FIRST STREET #400 SANTA ANA, CA 92705 | TRUSTMARK INSURANCE COMPANY | $21K | — | $21K | 11.83% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 59-1031071 PLAN ADMINISTRATOR | Claims processing; Non-monetary compensation; Participant communication; Named fiduciary; Float revenue; Other services; Contract Administrator; Direct payment from the plan Service code 12 | — | $112K |
| BB&H BENEFIT DESIGNS EIN 33-0782360 INS. BROKER | Insurance agents and brokers Service code 22 | — | $43K |
| VISION SERVICE PLAN EIN 94-1632821 PLAN ADMINISTRATOR | Plan Administrator Service code 14 | — | $22K |
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 | 1,686 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 58 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,746 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFLIATES | 323 | $2.8M |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,686 | $355K |
| Short-term disability(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,686 | $528K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,686 | $355K |
| Prescription drug(2 contracts, 2 carriers) | CIGNA HEALTHCARE OF CALIFORNIA | 1,958 | $15.6M |
| Other(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,686 | $528K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,958 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.