| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| TRAPANI DICKINS & ASSOCIATES3 | 515 SOUTH FLOWER STREET, SUITE 3510 LOS ANGELES, CA 90071 | KAISER FOUNDATION HEALTH PLAN INC. | $20K | — | $20K | 2.05% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | KAISER FOUNDATION HEALTH PLAN INC. | $16K | $17 | $16K | 1.62% |
| TRAPANI DICKINS & ASSOCIATES3 | 515 SOUTH FLOWER STREET, SUITE 3510 LOS ANGELES, CA 90071 | UNITED HEALTHCARE INSURANCE COMPANY | $5K | — | $5K | 2.76% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | UNITED HEALTHCARE INSURANCE COMPANY | $5K | — | $5K | 2.67% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFIT GROUP INC. | 5110 N. 40TH STREET, SUITE 234 PHOENIX, AZ 85018 | UNITED HEALTHCARE INSURANCE COMPANY | $4K | — | $4K | 2.16% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | DELTA DENTAL OF CALIFORNIA | $4K | — | $4K | 5.79% |
| TRAPANI DICKINS & ASSOCIATES3 | 515 SOUTH FLOWER STREET, SUITE 3510 LOS ANGELES, CA 90071 | DELTA DENTAL OF CALIFORNIA | $3K | — | $3K | 4.21% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | DELTA DENTAL OF CALIFORNIA | $1K | — | $1K | 5.65% |
| TRAPANI DICKINS & ASSOCIATES3 | 515 SOUTH FLOWER STREET, SUITE 3510 LOS ANGELES, CA 90071 | DELTA DENTAL OF CALIFORNIA | $1K | — | $1K | 4.35% |
| TRAPANI DICKINS & ASSOCIATES3 | 515 SOUTH FLOWER STREET, SUITE 3510 LOS ANGELES, CA 90071 | FIDELITY SECURITY LIFE INSURANCE COMPANY (EYEMED VISION CARE) | $1K | — | $1K | 7.43% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | FIDELITY SECURITY LIFE INSURANCE COMPANY (EYEMED VISION CARE) | $638 | — | $638 | 4.43% |
| TRAPANI DICKINS & ASSOCIATES3 | 515 SOUTH FLOWER STREET, SUITE 3510 LOS ANGELES, CA 90071 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $950 | $118 | $1K | 7.88% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $916 | $76 | $992 | 7.32% |
| THOMAS M. NIAL3 | 171 E. THOUSAND OAKS BLVD., STE 208 WESTLAKE VILLAGE, CA 91361 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $178 | — | $178 | 1.36% |
| DAVID K. BERLINGER3 | 30961 W. AGOURA RD., SUITE 109 WESTLAKE VILLAGE, CA 91361 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $171 | — | $171 | 1.31% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 6320 CANOGA AVE., 12TH FLOOR WOODLAND HILLS, CA 91367 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $144 | — | $144 | 1.10% |
| TRAPANI DICKINS & ASSOCIATES3 | 515 SOUTH FLOWER STREET, SUITE 3510 LOS ANGELES, CA 90071 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $455 | $85 | $540 | 5.53% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $442 | $55 | $497 | 5.09% |
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 | 227 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 228 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 181 | $1.1M |
| Dental(2 contracts) | DELTA DENTAL OF CALIFORNIA | 92 | $100K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY (EYEMED VISION CARE) | 212 | $14K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 227 | $23K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 46 | $13K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC. | 181 | $956K |
| Other(4 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 227 | $38K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 227 | — |
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."
No prospect flags tripped on this filing.