| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | KAISER FOUNDATION HEALTH PLAN INC | $50K | $273 | $50K | 4.67% |
| CALIFORNIA INSURANCE ADVOCATES INC3 Filed as: CALIFORNIA INS. AND OTHER AGENTS | 41960 AVENIDA DE ANITA TEMECULA, CA 92592 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5K | $277 | $5K | 4.63% |
| BEACON PATH, INC.3 Filed as: BEACON PATH INC. | 26522 LA ALAMEDA MISSION VIEJO, CA 92691 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5K | $0 | $5K | 3.93% |
| WILLIAM DOUGLAS DEACON3 | 5391 VANGUARD AVENUE GARDEN GROVE, CA 92845 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $37 | $3K | 2.71% |
| MARIANNA REBECCA WEAVER3 | 20092 CHAMPLAIN LAKE FOREST, CA 92630 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $191 | $3K | 2.23% |
| LESLIE GRAY3 Filed as: LESLIE DOREEN GRAY | 8583 IRVINE CENTER DRIVE IRVINE, CA 92618 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 1.77% |
| THOMAS MARTIN LEVINSTEIN3 | 16 PHEASANT LANE ALISO VIEJO, CA 92656 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $147 | $2K | 1.28% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $895 | $0 | $895 | 0.76% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | BLUE CROSS OF CALIFORNIA | $6K | $243 | $6K | 7.31% |
| LESLIE GRAY3 | 25 CALLE GAZAPO RANCHO SANTA MARGARITA, CA 92688 | BLUE CROSS OF CALIFORNIA | -$10 | $0 | -$10 | -0.01% |
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 | 194 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 200 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 304 | $1.1M |
| Dental | BLUE CROSS OF CALIFORNIA | 332 | $87K |
| Vision | BLUE CROSS OF CALIFORNIA | 332 | $87K |
| Life insurance(2 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 332 | $205K |
| Short-term disability | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 97 | $118K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 304 | $1.1M |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 332 | $205K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 332 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.