| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BB&H BENEFIT DESIGNS3 | 109 EAST VICTORIA STREET SANTA BARBARA, CA 93101 | CIGNA HEALTHCARE OF CALIFORNIA | $60K | — | $60K | 3.00% |
| BB&H BENEFIT DESIGNS3 | 109 EAST VICTORIA STREET SANTA BARBARA, CA 93101 | CIGNA HEALTH & LIFE COMPANY | $9K | $2K | $11K | 3.17% |
| BB&H BENEFIT DESIGNS3 | 109 EAST VICTORIA STREET SANTA BARBARA, CA 93101 | CIGNA LIFE INSURANCE COMPANY OF NORTH AMERICA | $13K | — | $13K | 13.74% |
| BB&H BENEFIT DESIGNS3 | 801 GARDEN STREET, SUITE 301 SANTA BARBARA, CA 93101 | ANTHEM BLUE CROSS | $0 | — | $0 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 59-1031071 TPA | Float revenue; Non-monetary compensation; Direct payment from the plan; Named fiduciary; Participant communication; Contract Administrator; Other services; Claims processing Service code 12 | — | $24K |
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 | 268 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 272 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTHCARE OF CALIFORNIA | 265 | $2.3M |
| Vision | ANTHEM BLUE CROSS | 287 | $27K |
| Life insurance | CIGNA LIFE INSURANCE COMPANY OF NORTH AMERICA | 268 | $95K |
| Short-term disability | CIGNA LIFE INSURANCE COMPANY OF NORTH AMERICA | 268 | $95K |
| Long-term disability | CIGNA LIFE INSURANCE COMPANY OF NORTH AMERICA | 268 | $95K |
| Prescription drug(2 contracts, 2 carriers) | CIGNA HEALTHCARE OF CALIFORNIA | 265 | $2.3M |
| Other | CIGNA LIFE INSURANCE COMPANY OF NORTH AMERICA | 268 | $95K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 287 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.