| 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) | — | $98K | $98K | 5.37% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | KAISER FOUNDATION HEALTH PLAN INC. | $41K | $906 | $42K | 5.10% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | DELTA DENTAL OF CALIFORNIA | $24K | — | $24K | 10.00% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUTE 1200 IRVINE, CA 92612 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $9K | $4K | $13K | 6.39% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $23K | $5K | $27K | 28.67% |
| WANGLIN, RONALD, CHASE3 | P.O. BOX 6030 PASADENA, CA 91102 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 1.13% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 91102 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $353 | — | $353 | 0.37% |
| 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 | — | $81 | $81 | 0.08% |
| 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 | $8K | $949 | $9K | 16.75% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | VISION SERVICE PLAN | $2K | — | $2K | 4.00% |
| MULLINTBG INSURANCE AGENCY SERVICES3 | 33174 COLLECTON CENTER DRIVE CHICAGO, IL 60693 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $369 | $3K | 10.29% |
| MULLIN BARENS SANFORD FINANCIAL3 | 3719 SANTA CLAUS LANE CARPINTERIA, CA 93013 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $911 | $240 | $1K | 4.06% |
| 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 | — | $519 | $519 | 1.83% |
| BARENS, KRISTIN, LUCILLE3 | 3719 SANTA CLAUS LANE CARPINTERIA, CA 93013 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $2 | $2 | 0.01% |
| MULLINTBG INSURANCE AGENCY SERVICES3 | 33174 COLLECTON CENTER DRIVE CHICAGO, IL 60693 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $164 | $2K | 9.14% |
| MULLIN BARENS SANFORD FINANCIAL3 | 3719 SANTA CLAUS LANE CARPINTERIA, CA 93013 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $323 | $2K | 9.13% |
| 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 | — | $367 | $367 | 1.96% |
| MULLINTBG INSURANCE AGENCY SERVICES3 | 33174 COLLECTION CENTER DRIVE CHICAGO, IL 60693 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 12.72% |
| MULLIN BARENS SANFORD FINANCIAL3 | 3719 SANTA CLAUS LANE CARPINTERIA, CA 93013 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $893 | — | $893 | 4.89% |
| 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 | — | $5 | $5 | 0.03% |
| MOORE BENEFITS INC.3 | 30 CORPORATE PARK, SUITE 106 IRVINE, CA 92606 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $250 | — | $250 | 2.33% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC. | 200 GALLERIA BLVD., SUITE 1950 ATLANTA, GA 30339 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $58 | — | $58 | 0.54% |
| DICKINS, BARTON J.3 Filed as: DICKINS, BARTON, JAMES | 1436 EL VAGO STREET LA CANADA, CA 91011 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $10 | — | $10 | 0.09% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC. | 200 GALLERIA BLVD., SUITE 1950 ATLANTA, GA 30339 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $370 | — | $370 | 4.78% |
| MULLINTBG INSURANCE AGENCY SERVICES3 | 33174 COLLECTON CENTER DRIVE CHICAGO, IL 60693 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $611 | $88 | $699 | 11.33% |
| MULLIN BARENS SANFORD FINANCIAL3 | 3719 SANTA CLAUS LANE CARPINTERIA, CA 93013 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $120 | $32 | $152 | 2.46% |
| 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 | — | $120 | $120 | 1.94% |
| BARENS, KRISTIN, LUCILLE3 | 3719 SANTA CLAUS LANE CARPINTERIA, CA 93013 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $3 | $2 | $5 | 0.08% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $432 | $66 | $498 | 9.85% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 91102 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $120 | — | $120 | 2.37% |
| WANGLIN, RONALD, CHASE3 | P.O. BOX 6030 PASADENA, CA 91102 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $85 | — | $85 | 1.68% |
| 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 | — | $36 | $36 | 0.71% |
| MULLINTBG INSURANCE AGENCY SERVICES3 | 33174 COLLECTON CENTER DRIVE CHICAGO, IL 60693 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $152 | $28 | $180 | 12.21% |
| 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 | — | $27 | $27 | 1.83% |
| MULLIN BARENS SANFORD FINANCIAL3 | 3719 SANTA CLAUS LANE CARPENTERIA, CA 93013 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $18 | $5 | $23 | 1.56% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $8 | — | $8 | 0.54% |
| BARENS, KRISTIN, LUCILLE3 | 3719 SANTA CLAUS LANE CAPENTERIA, CA 93013 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1 | $1 | $2 | 0.14% |
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 | 196 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 204 | 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) | 144 | $2.6M |
| Dental | DELTA DENTAL OF CALIFORNIA | 192 | $237K |
| Vision | VISION SERVICE PLAN | 179 | $42K |
| Life insurance(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 176 | $263K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 176 | $198K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 176 | $198K |
| Prescription drug | CALIFORNIA PHYSICIANS' SERVICE (BLUE SHIELD OF CALIFORNIA) | 118 | $1.8M |
| Other(12 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 176 | $500K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 192 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.