| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE IRVINE, CA 92612 | BLUE CROSS OF CALIFORNIA | $59K | $4K | $63K | 3.90% |
| ALLIANT INSURANCE SERVICES, INC.3 | 1301 DOVE STREET, SUITE 200 NEWPORT BEACH, CA 92660 | BLUE CROSS OF CALIFORNIA | $6K | — | $6K | 0.35% |
| VARIOUS - SEE ATTACHED3 Filed as: AFLAC - SEE ATTACHMENT | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $19K | $337 | $20K | 22.39% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $2K | $139 | $2K | 3.90% |
| ALLIANT INSURANCE SERVICES, INC.3 | 1301 DOVE STREET, SUITE 200 NEWPORT BEACH, CA 92660 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $203 | — | $203 | 0.35% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | ANTHEM LIFE INSURANCE COMPANY | $1K | $88 | $1K | 3.90% |
| ALLIANT INSURANCE SERVICES, INC.3 | 1301 DOVE STREET, SUITE 200 NEWPORT BEACH, CA 92660 | ANTHEM LIFE INSURANCE COMPANY | $128 | — | $128 | 0.35% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | EYEMED VISION CARE | $2K | — | $2K | 8.07% |
| ALLIANT INSURANCE SERVICES, INC.3 | 1301 DOVE STREET, SUITE 200 NEWPORT BEACH, CA 92660 | EYEMED VISION CARE | $434 | — | $434 | 1.66% |
| CONTINENTAL - SEE ATTACHMENT3 Filed as: CONTINENTAL AM - SEE ATTACHMENT | PO BOX 427 COLUMBIA, SC 29202 | CONTINENTAL AMERICAN INSURANCE COMPANY | $5K | — | $5K | 33.41% |
| ANGEL L. STEPHENS4 | PO BOX 36114 LOS ANGELES, CA 90036 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $201 | — | $201 | 3.67% |
| JOHN PACHECO4 | 3436 E SYCAMORE AVENUE VISALIA, CA 93292 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $156 | — | $156 | 2.85% |
| LISA N PEART4 | 1426 W 121ST STREET LOS ANGELES, CA 90047 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $150 | — | $150 | 2.74% |
| INTEGRETITY ASSET SERVICES LLC4 | 1873 KOYUKON DRIVE SOUTH LAKE TAHOE, CA 96150 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $76 | — | $76 | 1.39% |
| NICOLE BUTKOVICH4 | 199 MIRIAM WAY CARSON CITY, NV 89706 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $35 | — | $35 | 0.64% |
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 | 436 | 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) | 436 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 249 | $1.7M |
| Dental | BLUE CROSS OF CALIFORNIA | 249 | $1.6M |
| Vision | EYEMED VISION CARE | 375 | $26K |
| Life insurance | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 436 | $58K |
| Long-term disability | ANTHEM LIFE INSURANCE COMPANY | 436 | $36K |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 249 | $1.6M |
| Other(4 contracts, 4 carriers) | AFLAC | 436 | $165K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 436 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.