| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | CALIFORNIA PHYSICIANS' SERVICE (BLUE SHIELD OF CALIFORNIA) | $91K | $2K | $92K | 5.35% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | KAISER FOUNDATION HEALTH PLAN INC. | $54K | $118 | $55K | 6.98% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 91102 | KAISER FOUNDATION HEALTH PLAN INC. | -$16K | — | -$16K | -2.00% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | DELTA DENTAL OF CALIFORNIA | $25K | — | $25K | 10.00% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUTE 1200 IRVINE, CA 92612 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $9K | $4K | $13K | 5.99% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $25K | $6K | $31K | 50.41% |
| WANGLIN, RONALD, CHASE3 | P.O. BOX 6030 PASADENA, CA 91102 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $177 | $245 | $422 | 0.69% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 91102 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $58 | — | $58 | 0.09% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $11K | — | $11K | 20.00% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | $782 | $7K | 16.75% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | VISION SERVICE PLAN | $2K | — | $2K | 4.08% |
| MULLINTBG INSURANCE AGENCY SERVICES3 | 33174 COLLECTON CENTER DRIVE CHICAGO, IL 60693 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $1K | $4K | 12.71% |
| MULLIN BARENS SANFORD FINANCIAL3 | 3719 SANTA CLAUS LANE CARPINTERIA, CA 93013 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $290 | $2K | 4.40% |
| BARENS, KRISTIN, LUCILLE3 | 3719 SANTA CLAUS LANE CARPINTERIA, CA 93013 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.01% |
| MULLINTBG INSURANCE AGENCY SERVICES3 | 33174 COLLECTION CENTER DRIVE CHICAGO, IL 60693 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $3K | — | $3K | 13.02% |
| MULLIN BARENS SANFORD FINANCIAL3 | 3719 SANTA CLAUS LANE CARPINTERIA, CA 93013 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 4.69% |
| M FINANCIAL HOLDINGS INC3 Filed as: M FINANCIAL HOLDINGS INC. | 1125 NW COUCH ST., SUITE 900 PORTLAND, OR 97209 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $722 | $722 | 3.00% |
| MULLINTBG INSURANCE AGENCY SERVICES3 | 33174 COLLECTON CENTER DRIVE CHICAGO, IL 60693 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $325 | $2K | 10.30% |
| MULLIN BARENS SANFORD FINANCIAL3 | 3719 SANTA CLAUS LANE CARPINTERIA, CA 93013 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $314 | $2K | 9.38% |
| MOORE BENEFITS INC.3 | 30 CORPORATE PARK, SUITE 106 IRVINE, CA 92606 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $263 | — | $263 | 2.12% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC. | 200 GALLERIA BLVD., SUITE 1950 ATLANTA, GA 30339 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $52 | — | $52 | 0.42% |
| DICKINS, BARTON J.3 Filed as: DICKINS, BARTON, JAMES | 1436 EL VAGO STREET LA CANADA, CA 91011 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $9 | — | $9 | 0.07% |
| MULLINTBG INSURANCE AGENCY SERVICES3 | 33174 COLLECTON CENTER DRIVE CHICAGO, IL 60693 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $847 | $251 | $1K | 12.96% |
| MULLIN BARENS SANFORD FINANCIAL3 | 3719 SANTA CLAUS LANE CARPINTERIA, CA 93013 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $171 | $35 | $206 | 2.43% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $7 | $7 | $14 | 0.17% |
| BARENS, KRISTIN, LUCILLE3 | 3719 SANTA CLAUS LANE CARPINTERIA, CA 93013 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.05% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC. | 200 GALLERIA BLVD., SUITE 1950 ATLANTA, GA 30339 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $122 | — | $122 | 1.65% |
| DICKINS, BARTON J.3 Filed as: DICKINS, BARTON, JAMES | 1436 EL VAGO STREET LA CANADA, CA 91011 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $12 | — | $12 | 0.16% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $974 | $224 | $1K | 18.89% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 91102 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $443 | — | $443 | 6.99% |
| WANGLIN, RONALD, CHASE3 | P.O. BOX 6030 PASADENA, CA 91102 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $327 | — | $327 | 5.16% |
| BENEFIT ADVISORS NETWORK LLC3 Filed as: BENEFIT ADVISORS NETWORK | 6830 COCHRAN ROAD SOLON, OH 44139 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $70 | $141 | $211 | 3.33% |
| MULLINTBG INSURANCE AGENCY SERVICES3 | 33174 COLLECTON CENTER DRIVE CHICAGO, IL 60693 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $246 | $63 | $309 | 10.20% |
| MULLIN BARENS SANFORD FINANCIAL3 | 3719 SANTA CLAUS LANE CARPENTERIA, CA 93013 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $23 | $4 | $27 | 0.89% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $26 | — | $26 | 0.86% |
| BARENS, KRISTIN, LUCILLE3 | 3719 SANTA CLAUS LANE CAPENTERIA, CA 93013 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.07% |
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 | 178 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 185 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE (BLUE SHIELD OF CALIFORNIA) | 156 | $2.5M |
| Dental | DELTA DENTAL OF CALIFORNIA | 188 | $255K |
| Vision | VISION SERVICE PLAN | 175 | $40K |
| Life insurance(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 197 | $268K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 197 | $210K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 197 | $210K |
| Prescription drug | CALIFORNIA PHYSICIANS' SERVICE (BLUE SHIELD OF CALIFORNIA) | 113 | $1.7M |
| Other(12 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 197 | $486K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 197 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.