| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | KAISER FOUNDATION HEALTH PLANS INC | $59K | $913 | $60K | 4.53% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | STANDARD INSURANCE COMPANY | $5K | $893 | $6K | 3.38% |
| PLANSOURCE BENEFITS ADMINISTRATION3 Filed as: PLANSOURCE BENEFITS ADMIN INC | PO BOX 1313 ORLANDO, FL 32802 | STANDARD INSURANCE COMPANY | — | $5K | $5K | 2.73% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | $2K | $8K | 13.87% |
| PLANSOURCE BENEFITS ADMINISTRATION3 | 101 S GARLAND AVENUE, SUITE 203 ORLANDO, FL 32801 | METROPOLITAN LIFE INSURANCE COMPANY | — | $2K | $2K | 3.08% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | SAFEGUARD HEALTH PLANS, INC. | $2K | $548 | $2K | 13.42% |
| PLANSOURCE BENEFITS ADMINISTRATION3 | 101 S GARLAND AVENUE, SUITE 203 ORLANDO, FL 32801 | SAFEGUARD HEALTH PLANS, INC. | — | $473 | $473 | 2.99% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | STANDARD INSURANCE COMPANY | $759 | $68 | $827 | 6.97% |
| PLANSOURCE BENEFITS ADMINISTRATION3 Filed as: PLANSOURCE BENEFITS ADMIN INC | PO BOX 1313 ORLANDO, FL 32802 | STANDARD INSURANCE COMPANY | — | $328 | $328 | 2.77% |
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 | 175 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 176 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLANS INC | 145 | $1.3M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 183 | $75K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 183 | $59K |
| Life insurance | STANDARD INSURANCE COMPANY | 142 | $12K |
| Long-term disability | STANDARD INSURANCE COMPANY | 142 | $187K |
| Prescription drug | KAISER FOUNDATION HEALTH PLANS INC | 145 | $1.3M |
| Other | STANDARD INSURANCE COMPANY | 142 | $12K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 183 | — |
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.