| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BURNHAM BENEFITS INSURANCE SERVICES | 2211 MICHELSON DR STE 1200 IRVINE, CA 926120304 | KAISER FOUNDATION HEALTH PLANS, INC. | $63K | — | $63K | 3.46% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS5 | PO BOX 9201 AUSTIN, TX 787669201 | METROPOLITAN LIFE INSURANCE COMPANY | $13K | $3K | $17K | 33.57% |
| BURNHAM BENEFITS INSURANCE SERVICES3 Filed as: BURNHAM BENEFITS INS SERVICES | 2211 MICHELSON DR STE 1200 IRVINE, CA 926120304 | METROPOLITAN LIFE INSURANCE COMPANY | — | $699 | $699 | 1.42% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 604502215 | METROPOLITAN LIFE INSURANCE COMPANY | — | $576 | $576 | 1.17% |
| BURNHAM BENEFITS INSURANCE SERVICES3 Filed as: BURNHAM BENEFITS INS SERVICES | 2211 MICHELSON DR STE 1200 IRVINE, CA 926120304 | SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION | — | $389 | $389 | 1.41% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 604502215 | SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION | — | $321 | $321 | 1.17% |
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 | 155 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 155 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLANS, INC. | 302 | $1.8M |
| Dental | SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION | 234 | $28K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 271 | $49K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 271 | $49K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 271 | $49K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 302 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.