| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BURNHAM BENEFITS INSURANCE SERVICES3 Filed as: BURNHAM BENEFITS INS. SVCS. | 2211 MICHELSON DRIVE SUITE 1200 IRVINE, CA 92612 | KAISER FOUNDATION HEALTH PLAN INC | $72K | $5K | $77K | 4.65% |
| BURNHAM BENEFITS INSURANCE SERVICES3 Filed as: BURNHAM BENEFITS INS. SVCS. | 1100 LARKSPUR LANDING CIRCLE SUITE 180 LARKSPUR, CA 94939 | HARTFORD LIFE AND ACCIDENT | $142K | $0 | $142K | 15.14% |
| BURNHAM BENEFITS INSURANCE SERVICES3 Filed as: BURNHAM BENEFITS INS. SVCS. | 2211 MICHELSON DRIVE SUITE 1200 IRVINE, CA 92612 | HARTFORD LIFE AND ACCIDENT | $0 | $9K | $9K | 0.97% |
| BURNHAM BENEFITS INSURANCE SERVICES3 Filed as: BURNHAM BENEFITS INS. SVCS. | 2211 MICHELSON DRIVE SUITE 1200 IRVINE, CA 92612 | VISION SERVICE PLAN | $7K | $0 | $7K | 5.00% |
| BURNHAM BENEFITS INSURANCE SERVICES3 Filed as: BURNHAM BENEFITS INS. SVCS. | 1100 LARKSPUR LANDING CIRCLE SUITE 180 LARKSPUR, CA 94939 | UNITEDHEALTHCARE INSURANCE COMPANY | $9K | $0 | $9K | 6.18% |
| CHRISTINE M. MCCULLUGH3 Filed as: CHRISTINE M MCCULLUGH | 14715 NE 95TH STREET SUITE 200 REDMOND, WA 98052 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $0 | $6K | 14.80% |
| BURNHAM BENEFITS INSURANCE SERVICES3 Filed as: BURNHAM BENEFITS INS. SVCS. | 2211 MICHELSON DRIVE SUITE 1200 IRVINE, CA 92612 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 4.93% |
| BURNHAM BENEFITS INSURANCE SERVICES3 Filed as: BURNHAM BENEFITS INS. SVCS. | 1100 LARKSPUR LANDING CIRCLE SUITE 180 LARKSPUR, CA 94939 | AETNA LIFE INSURANCE COMPANY | $2K | $63 | $2K | 5.57% |
| BURNHAM BENEFITS INSURANCE SERVICES3 Filed as: BURNHAM BENEFITS INS. SVCS. | 1100 LARKSPUR LANDING CIRCLE SUITE 180 LARKSPUR, CA 94939 | CLAREMONT | $1K | $0 | $1K | 4.76% |
| BURNHAM BENEFITS INSURANCE SERVICES3 Filed as: BURNHAM BENEFITS INS. SVCS. | 1100 LARKSPUR LANDING CIRCLE SUITE 180 LARKSPUR, CA 94939 | HYATT LEGAL PLANS | $2K | $0 | $2K | 10.00% |
| BURNHAM BENEFITS INSURANCE SERVICES3 Filed as: BURNHAM BENEFITS INS. SVCS. | TWO PIERCE PLACE 14TH FLOOR ITASCA, IL 60143 | HYATT LEGAL PLANS | $0 | $58 | $58 | 0.24% |
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 | 1,045 | 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) | 1,045 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 337 | $1.8M |
| Dental(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 176 | $182K |
| Vision(2 contracts, 2 carriers) | VISION SERVICE PLAN | 1,076 | $289K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 1,045 | $937K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 1,045 | $937K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 1,045 | $937K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 337 | $1.7M |
| Other(5 contracts, 5 carriers) | HARTFORD LIFE AND ACCIDENT | 1,045 | $1.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,076 | — |
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.