| 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. | $45K | $1K | $47K | 4.10% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | UNITED HEALTHCARE INSURANCE COMPANY | $20K | — | $20K | 6.00% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFIT GROUP INC - CA | 5110 N 40TH ST., SUITE 234 PHOENIX, AZ 85018 | UNITED HEALTHCARE INSURANCE COMPANY | $8K | — | $8K | 2.50% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | UNITED CONCORDIA INSURANCE COMPANY | $7K | — | $7K | 8.36% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. | $2K | — | $2K | 8.36% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | VISION SERVICE PLAN | $1K | — | $1K | 5.81% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $232 | $2K | 16.75% |
| THOMAS MEANS3 Filed as: THOMAS MICHAEL NIAL | 171 E. THOUSAND OAKS BLVD., STE 208 THOUSAND OAKS, CA 91360 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $99 | — | $99 | 0.91% |
| DAVID K. BERLINGER3 | 30961 W. AGOURA RD., SUITE 109 WESTLAKE VILLAGE, CA 91361 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $94 | — | $94 | 0.87% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $67 | — | $67 | 0.62% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 1800 QUAIL ST., SUITE 110 NEWPORT BEACH, CA 92660 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $16 | — | $16 | 0.15% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $917 | $160 | $1K | 11.75% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $51 | — | $51 | 1.51% |
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 | 228 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 230 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 186 | $1.5M |
| Dental(2 contracts, 2 carriers) | UNITED CONCORDIA INSURANCE COMPANY | 105 | $98K |
| Vision | VISION SERVICE PLAN | 156 | $18K |
| Life insurance(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 228 | $33K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 46 | $11K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC. | 186 | $1.1M |
| Other(4 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 228 | $37K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 228 | — |
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.