| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | AETNA LIFE INSURANCE CO. | $29K | — | $29K | 4.17% |
| THE BALDWIN GROUP WEST LLC3 | 4211 BOY SCOUT BLVD SUITE 900 TAMPA, FL 33607 | AETNA LIFE INSURANCE CO. | $13K | $5K | $17K | 2.51% |
| THE BALDWIN GROUP WEST LLC3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | KAISER FOUNDATION HEALTH PLAN INC | $16K | $29 | $16K | 4.49% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | AETNA HEALTH, INC. | $7K | — | $7K | 3.61% |
| THE BALDWIN GROUP WEST LLC3 | 4211 BOY SCOUT BLVD SUITE 900 TAMPA, FL 33607 | AETNA HEALTH, INC. | $3K | — | $3K | 1.62% |
| THE BALDWIN GROUP WEST LLC3 | 4211 BOY SCOUT BLVD SUITE 900 TAMPA, FL 33607 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $5K | $2K | $7K | 17.03% |
| COMPSYCH5 Filed as: COMPSYCH 35-3739783 | — | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $989 | $989 | 2.38% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $28 | $28 | 0.07% |
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 | 134 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 139 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | AETNA LIFE INSURANCE CO. | 171 | $1.3M |
| Dental | AETNA LIFE INSURANCE CO. | 171 | $694K |
| Vision | AETNA LIFE INSURANCE CO. | 171 | $694K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 140 | $42K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 140 | $42K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 140 | $42K |
| Prescription drug(3 contracts, 3 carriers) | AETNA LIFE INSURANCE CO. | 171 | $1.3M |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 140 | $42K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 171 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.