| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $171K | $671 | $172K | 2.45% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 1100 LARKSPUR LANDING CIRCLE SUITE 180 LARKSPUR, CA 94939 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $17K | $0 | $17K | 0.24% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 1100 LARKSPUR LANDING CIRCLE SUITE 180 LARKSPUR, CA 94939 | KAISER FOUNDATION HEALTH PLAN INC | $146K | $0 | $146K | 3.12% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | KAISER FOUNDATION HEALTH PLAN INC | $0 | $2K | $2K | 0.04% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 1100 LARKSPUR LANDING CIRCLE SUITE 180 LARKSPUR, CA 94939 | DELTA DENTAL OF CALIFORNIA | $27K | $0 | $27K | 3.09% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 1100 LARKSPUR LANDING CIRCLE SUITE 180 LARKSPUR, CA 94939 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $22K | $0 | $22K | 3.12% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $16K | $0 | $16K | 2.95% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | VISION SERVICE PLAN | $5K | $0 | $5K | 2.78% |
| STEVEN RAY GRIFFIN3 | 2000 MORRIS AVENUE, SUITE 1400 BIRMINGHAM, AL 35203 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $85 | $0 | $85 | 2.53% |
| PORTAL INSURANCE AGENCY, INC.3 Filed as: PORTAL INSURANCE AGENCY INC | 1277 TREAT BOULEVARD SUITE 650 WALNUT CREEK, CA 94597 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $22 | $0 | $22 | 0.66% |
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 | 1,104 | 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) | 1,104 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 600 | $12.3M |
| Dental | DELTA DENTAL OF CALIFORNIA | 1,453 | $876K |
| Vision(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 920 | $7.2M |
| Life insurance(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,104 | $693K |
| Short-term disability(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,104 | $693K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,104 | $690K |
| Prescription drug(4 contracts, 4 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 600 | $12.3M |
| Other(4 contracts, 4 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1,104 | $7.8M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,453 | — |
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."
No prospect flags tripped on this filing.