| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN | 701 S PARKER STREET 8TH FLOOR ORANGE, CA 92868 | CALIFORNIA PHYSICIANS' SERVICE | $180K | — | $180K | 5.00% |
| BURNS EMPLOYEE BENEFITS INS SVC3 Filed as: BURNS EMPLOYEE BENEFITS INS SVCS | 5653 MAXWELTON ROAD OAKLAND, CA 94618 | CALIFORNIA PHYSICIANS' SERVICE | $180K | — | $180K | 5.00% |
| BURNS EMPLOYEE BENEFITS INS SVC3 Filed as: BURNS EMPLOYEE BENEFITS INS SVCS | 5653 MAXWELTON ROAD OAKLAND, CA 94618 | KAISER FOUNDATION HEALTH PLAN INC | $14K | — | $14K | 2.98% |
| BURNS EMPLOYEE BENEFITS INS SVC3 Filed as: BURNS EMPLOYEE BENEFITS INS SVCS | 5653 MAXWELTON ROAD OAKLAND, CA 94618 | DELTA DENTAL OF CALIFORNIA | $41K | — | $41K | 10.00% |
| BURNS EMPLOYEE BENEFITS INS SVC3 Filed as: BURNS EMPLOYEE BENEFITS INS SVCS | 5653 MAXWELTON ROAD PIEDMONT, CA 94618 | VISION SERVICE PLAN | $3K | — | $3K | 2.54% |
| BURNS EMPLOYEE BENEFITS INS SVC3 Filed as: BURNS EMPLOYEE BENEFITS INS SVCS | 5653 MAXWELTON ROAD PIEDMONT, CA 94618 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 10.00% |
| BURNS EMPLOYEE BENEFITS INS SVC3 Filed as: BURNS EMPLOYEE BENEFITS INS SVCS | 5653 MAXWELTON ROAD PIEDMONT, CA 94618 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 10.00% |
| BURNS EMPLOYEE BENEFITS INS SVC3 | 5653 MAXWELTON ROAD PIEDMONT, CA 94618 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 10.00% |
| BURNS EMPLOYEE BENEFITS INS SVC3 Filed as: BURNS EMPLOYEE BENEFITS INS SVCS | 5653 MAXWELTON ROAD PIEDMONT, CA 94618 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| BURNS EMPLOYEE BENEFITS INS SVC3 Filed as: BURNS EMPLOYEE BENEFITS INS SVCS | 5653 MAXWELTON ROAD PIEDMONT, CA 94618 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| BURNS EMPLOYEE BENEFITS INS SVC3 Filed as: BURNS EMPLOYEE BENEFITS INS SVCS | 5653 MAXWELTON ROAD PIEDMONT, CA 94618 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 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 | 357 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 357 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 605 | $4.1M |
| Dental(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 719 | $4.0M |
| Vision(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 605 | $3.7M |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 350 | $63K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 351 | $15K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 351 | $37K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 605 | $4.1M |
| Other(4 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 350 | $112K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 719 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.