| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | BLUE CROSS OF CALIFORNIA | $151K | $3K | $154K | 4.31% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | BLUE CROSS OF CALIFORNIA | $29K | — | $29K | 0.81% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $59K | — | $59K | 24.03% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $140 | $140 | 0.06% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | KAISER FOUNDATION HEALTH PLAN INC | $11K | — | $11K | 4.79% |
| USI INSURANCE SERVICES LLC3 | 150 N MICHIGAN AVE STE 3900 CHICAGO, IL 60601 | KAISER FOUNDATION HEALTH PLAN INC | $972 | — | $972 | 0.42% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | METROPOLITAN LIFE INSURANCE COMPANY | $7K | $13 | $7K | 3.11% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | — | $4K | $4K | 1.91% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | 201 MISSION ST FL 11 SAN FRANCISCO, CA 94105 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $65 | $2K | 1.09% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO | $3K | — | $3K | 3.64% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 15901 RED HILL AVENUE TUSTIN, CA 92780 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO | $704 | — | $704 | 0.97% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO | $307 | — | $307 | 0.42% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | KAISER FOUNDATION HEALTH PLAN INC | $2K | — | $2K | 3.85% |
| USI INSURANCE SERVICES LLC3 | 150 N MICHIGAN AVE STE 3900 CHICAGO, IL 60601 | KAISER FOUNDATION HEALTH PLAN INC | $2K | — | $2K | 3.24% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | SAFEGUARD HEALTH PLANS, INC., A FLORIDA CORPORATION | $243 | — | $243 | 1.87% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | SAFEGUARD HEALTH PLANS, INC., A FLORIDA CORPORATION | — | $206 | $206 | 1.59% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | 201 MISSION ST FL 11 SAN FRANCISCO, CA 94105 | SAFEGUARD HEALTH PLANS, INC., A FLORIDA CORPORATION | $156 | — | $156 | 1.20% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | METLIFE LEGAL PLANS | $1K | — | $1K | 10.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | — | $432 | $432 | 3.84% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $342 | — | $342 | 3.04% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | 201 MISSION ST FL 11 SAN FRANCISCO, CA 94105 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $134 | — | $134 | 1.19% |
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 | 770 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 779 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 502 | $3.9M |
| Dental(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 434 | $236K |
| Vision(2 contracts) | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO | 582 | $73K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 823 | $246K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 823 | $246K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 823 | $246K |
| Prescription drug(3 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 502 | $3.9M |
| Other(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 823 | $258K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 823 | — |
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."
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.