| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | AETNA LIFE INSURANCE COMPANY | $238K | $19 | $238K | 2.98% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 1100 LARKSPUR LANDING CIRCLE SUITE 180 LARKSPUR, CA 94939 | DELTA DENTAL OF CALIFORNIA | $36K | $0 | $36K | 5.15% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | KAISER FOUNDATION HEALTH PLAN INC | $10K | $101 | $10K | 4.88% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | AETNA HEALTH OF CALIFORNIA INC | $5K | $0 | $5K | 3.02% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | $9K | $0 | $9K | 10.73% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | $0 | $6K | 15.00% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | ARAG INSURANCE COMPANY | $3K | $0 | $3K | 10.00% |
| EMPYREAN INSURANCE SERVICES, INC.5 Filed as: EMPYREAN BENEFIT SOLUTIONS | 3010 BRIARPARK DRIVE, SUITE 8000 HOUSTON, TX 77042 | ARAG INSURANCE COMPANY | $0 | $2K | $2K | 5.00% |
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 | 542 | 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) | 542 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | AETNA LIFE INSURANCE COMPANY | 1,197 | $8.4M |
| Dental | DELTA DENTAL OF CALIFORNIA | 1,373 | $695K |
| Vision | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | 1,273 | $84K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 542 | $37K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 542 | $37K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 542 | $37K |
| Prescription drug(3 contracts, 3 carriers) | AETNA LIFE INSURANCE COMPANY | 1,197 | $8.4M |
| Other(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 542 | $68K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,373 | — |
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.