| 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 | $67K | — | $67K | 2.19% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE SUITE 1200 IRVINE, CA 92612 | KAISER FOUNDATION HEALTH PLAN INC | $10K | $3K | $12K | 1.33% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE SUITE 1200 IRVINE, CA 92612 | METROPOLITAN LIFE INSURANCE COMPANY | $43K | $7K | $50K | 5.82% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE SUITE 1200 IRVINE, CA 92612 | METROPOLITAN LIFE INSURANCE COMPANY | $27K | $3K | $30K | 8.01% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE SUITE 1200 IRVINE, CA 92612 | KAISER FOUNDATION HEALTH PLAN INC | $6K | — | $6K | 2.83% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE SUITE 1200 IRVINE, CA 92612 | METROPOLITAN LIFE INSURANCE COMPANY | $34K | $9K | $43K | 25.09% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE SUITE 1200 IRVINE, CA 92612 | DELTA DENTAL OF WASHINGTON | $5K | — | $5K | 5.00% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE SUITE 1200 IRVINE, CA 92612 | KAISER FOUNDATION HEALTH PLAN INC | $184 | $20 | $204 | 1.33% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES, INC. EIN 41-1289245 CLAIMS PROCESSOR | Claims processing; Other services Service code 12 | — | $1.8M |
| METROPOLITAN LIFE INSURANCE COMPANY EIN 13-5581829 | Claims processing; Contract Administrator Service code 12 | — | $111K |
| BURNHAM BENEFITS INSURANCE SERVICES EIN 33-0643611 BROKER | Other commissions Service code 55 | — | $0 |
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 | 2,157 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 18 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,175 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 736 | $3.4M |
| Dental | DELTA DENTAL OF WASHINGTON | 95 | $110K |
| Vision | EYEMED VISION CARE | 5,583 | $76K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 5,119 | $859K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 923 | $378K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 923 | $378K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 5,119 | $859K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,583 | — |
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.