| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WGB BENEFITS INSURANCE SERVICES3 | 15901 REDHILL AVENUE, SUITE 100 TUSTIN, CA 92780 | BLUE CROSS OF CALIFORNIA | $19K | — | $19K | 0.72% |
| BURNHAM BENEFITS INSURANCE SERVICES3 Filed as: BURNHAM BENEFITS INSURANCE SERVICE | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $26K | — | $26K | 7.20% |
| BURNHAM BENEFITS INSURANCE SERVICES3 Filed as: BURNHAM BENEFITS INSURANCE SERVICE | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $4K | — | $4K | 5.00% |
| BURNHAM BENEFITS INSURANCE SERVICES3 Filed as: BURNHAM BENEFITS INSURANCE SERVICE | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | UNITED HEALTHCARE INSURANCE COMPANY | $1K | — | $1K | 6.05% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INSURANCE CA | 6200 CANOGA AVENUE, SUITE 300 WOODLAND HILLS, CA 91367 | UNITED HEALTHCARE INSURANCE COMPANY | $567 | — | $567 | 2.63% |
| WGB BENEFITS INSURANCE SERVICES3 | 15901 REDHILL AVENUE, SUITE 100 TUSTIN, CA 92780 | UNITED HEALTHCARE INSURANCE COMPANY | — | — | $0 | 0.00% |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 272 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | 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)(3 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 200 | $2.7M |
| Dental | BLUE CROSS OF CALIFORNIA | 200 | $2.6M |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 272 | $367K |
| Life insurance | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 272 | $367K |
| Short-term disability | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 272 | $367K |
| Long-term disability | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 272 | $367K |
| Prescription drug(3 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 200 | $2.7M |
| Other | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 272 | $367K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 272 | — |
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.