| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | CALIFORNIA PHYSICIANS SERVICE | $52K | $0 | $52K | 1.53% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF CALIFORNIA, INC. | 18101 VON KARMEN AVENUE, SUITE 600 IRVINE, CA 92612 | CALIFORNIA PHYSICIANS SERVICE | $50K | $2K | $52K | 1.52% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF CALIFORNIA, INC. | PO BOX 101162 PASADENA, CA 91189 | KAISER FOUNDATION HEALTH PLAN INC | $54K | $0 | $54K | 1.84% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 1100 LARKSPUR LANDING CIRCLE SUITE 180 LARKSPUR, CA 94939 | KAISER FOUNDATION HEALTH PLAN INC | $40K | $0 | $40K | 1.37% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF CALIFORNIA, INC. | PO BOX 101162 PASADENA, CA 91189 | VISION SERVICE PLAN | $1K | $0 | $1K | 1.84% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | VISION SERVICE PLAN | $906 | $0 | $906 | 1.47% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2220 DOUGLAS BOULEVARD, SUITE 170 ROSEVILLE, CA 95661 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 5.01% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF CALIFORNIA, INC. | WILIS LOCKBOX 100485 LOS ANGELES, CA 90065 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 4.99% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $184 | $184 | 0.38% |
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 | 526 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 530 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 390 | $6.3M |
| Vision | VISION SERVICE PLAN | 434 | $62K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 525 | $48K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 525 | $48K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 390 | $6.3M |
| Other(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 525 | $62K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 525 | — |
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.