| 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 | $547 | $50K | 5.27% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | UNITED HEALTHCARE INSURANCE COMPANY | $26K | — | $26K | 5.51% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFIT GROUP INC - CA | 2251 DOUGLAS BLVD STE 115 ROSEVILLE, CA 95661 | UNITED HEALTHCARE INSURANCE COMPANY | $11K | — | $11K | 2.30% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | UNITED CONCORDIA INSURANCE COMPANY | $9K | $4K | $13K | 14.17% |
| VOLUNTARY BENEFIT ADVISORS3 | 2400 MAIN ST SUITE 200 IRVINE, CA 92614 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $8K | $805 | $8K | 19.52% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 7676 N PALM AVE STE 106 FRESNO, CA 93711 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $235 | $4K | 8.24% |
| THOMAS MEANS3 Filed as: THOMAS MICHAEL NIAL | 171 E. THOUSAND OAKS BLVD., STE 208 THOUSAND OAKS, CA 91360 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $48 | — | $48 | 0.11% |
| DAVID K. BERLINGER3 | 30961 W. AGOURA RD., SUITE 109 WESTLAKE VILLAGE, CA 91361 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $46 | — | $46 | 0.11% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 1800 QUAIL ST., SUITE 110 NEWPORT BEACH, CA 92660 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $16 | — | $16 | 0.04% |
| VOLUNTARY BENEFIT ADVISORS3 Filed as: VOLUNTARY BENEFIT ADVISORS, INC | 2400 MAIN ST SUITE 200 IRVINE, CA 92614 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | $854 | $9K | 23.06% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 7676 N PALM AVE STE 106 FRESNO, CA 93711 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $252 | $4K | 9.61% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRIVNE, CA 92612 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $398 | $4K | 15.69% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRIVNE, CA 92612 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $314 | $2K | 10.69% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | VISION SERVICE PLAN | $1K | — | $1K | 5.80% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. | $2K | $629 | $2K | 14.05% |
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 | 224 | 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) | 225 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 164 | $1.4M |
| Dental(2 contracts, 2 carriers) | UNITED CONCORDIA INSURANCE COMPANY | 147 | $106K |
| Vision | VISION SERVICE PLAN | 163 | $18K |
| Life insurance(3 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 235 | $87K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 127 | $43K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC. | 164 | $957K |
| Other(4 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 235 | $126K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 235 | — |
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.