| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KRISTEN M ALLISON3 Filed as: KRISTEN ALLISON | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | BLUECROSS BLUESHIELD OF TENNESEE, INC | $46K | $0 | $46K | 4.02% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | STANDARD INSURANCE COMPANY | $4K | $2K | $6K | 8.05% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | DELTA DENTAL OF TENNESSEE | $3K | $0 | $3K | 4.00% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $119 | $3K | 14.93% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | VISION SERVICE PLAN | $943 | $0 | $943 | 6.74% |
| ENROLLEASE3 Filed as: ENROLLEASE INC | 1980 FESTIVAL PLAZA DRIVE SUITE 810 LAS VEGAS, NV 89135 | VISION SERVICE PLAN | $196 | $0 | $196 | 1.40% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $44 | $1K | 10.72% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | CLAREMONT BEHAVIORAL SERVICES, INC | $281 | $0 | $281 | 3.40% |
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 | 90 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 90 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF TENNESEE, INC | 164 | $1.1M |
| Dental | DELTA DENTAL OF TENNESSEE | 175 | $68K |
| Vision | VISION SERVICE PLAN | 83 | $14K |
| Life insurance | STANDARD INSURANCE COMPANY | 133 | $75K |
| Short-term disability(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 133 | $86K |
| Long-term disability | STANDARD INSURANCE COMPANY | 133 | $75K |
| Prescription drug | BLUECROSS BLUESHIELD OF TENNESEE, INC | 164 | $1.1M |
| Other(3 contracts, 3 carriers) | STANDARD INSURANCE COMPANY | 175 | $102K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 175 | — |
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.