| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | WESTERN HEALTH ADVANTAGE | $37K | $0 | $37K | 4.18% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | KAISER FOUNDATION HEALTH PLAN, INC. | $47K | $0 | $47K | 5.56% |
| GARY ERICKSON3 | 6770 STANFORD RANCH ROAD SUITE 1082 ROSEVILLE, CA 95661 | KAISER FOUNDATION HEALTH PLAN, INC. | -$155 | $0 | -$155 | -0.02% |
| SIDERS INSURANCE SOLUTIONS LLC3 Filed as: SIDERS INSURANCE SOLUTIONS, LLC | PO BOX 136 RESCUE, CA 95672 | KAISER FOUNDATION HEALTH PLAN, INC. | -$706 | $0 | -$706 | -0.08% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | DELTA DENTAL | $10K | $0 | $10K | 10.00% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $2K | $0 | $2K | 9.80% |
| PROFESSIONAL GROUP PLAN INC3 Filed as: PROFESSIONAL GROUP PLAN, INC. | UNKOWN CARMICHAEL, CA 95608 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $1K | $0 | $1K | 4.90% |
| SIDERS INSURANCE SOLUTIONS LLC3 Filed as: SIDERS INSURANCE SOLUTIONS, LLC | UNKNOWN CARMICHAEL, CA 95608 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $3 | $0 | $3 | 0.01% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE IRVINE, CA 92612 | HARTFORD LIFE AND ACCIDENT | $1K | $77 | $1K | 5.60% |
| SAMANTHA SIDERS3 Filed as: SAMANTHA L. SIDERS | 3108 PONTE MORINO DRIVE, SUITE 111 CAMERON PARK, CA 95682 | HARTFORD LIFE AND ACCIDENT | -$27 | $0 | -$27 | -0.12% |
| GARY ERICKSON3 Filed as: GARY W. ERICKSON | 901 SUNRISE AVENUE ROSEVILLE, CA 95661 | HARTFORD LIFE AND ACCIDENT | -$30 | $0 | -$30 | -0.14% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | DELTACARE | $2K | $0 | $2K | 10.00% |
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 | 335 | 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) | 337 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | WESTERN HEALTH ADVANTAGE | 152 | $1.7M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL | 130 | $120K |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 185 | $22K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 321 | $22K |
| Prescription drug(2 contracts, 2 carriers) | WESTERN HEALTH ADVANTAGE | 152 | $1.7M |
| Other | HARTFORD LIFE AND ACCIDENT | 321 | $22K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 321 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
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.