| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | CALIFORNIA PHYSICIANS SERVICE | $62K | $2K | $63K | 3.10% |
| KATHLEEN LEININGER INS SERVICES INC3 | 8880 BENSON AVENUE, SUITE 106 MONTCLAIR, CA 91763 | AFLAC | $9K | $627 | $10K | 7.06% |
| MJ INSURANCE3 Filed as: TIFFANY KING AND VARIOUS AGENTS | 1010 LAKE STREET, SUITE 430 OAK PARK, IL 60301 | AFLAC | $9K | $596 | $9K | 6.43% |
| DOUGLAS J SUCHECKI3 Filed as: DOUGLAS SUCHECKI | 3850 VINE STREET, SUITE 130 RIVERSIDE, CA 92507 | AFLAC | $3K | $249 | $3K | 2.27% |
| DIANA HOMA3 | 8880 BENSON AVENUE, SUITE 106 MONTCLAIR, CA 91763 | AFLAC | $2K | $100 | $2K | 1.74% |
| CYNTHIA JAYNE GOODNICK3 Filed as: CYNTHIA GOODNICK | 8880 BENSON AVENUE, SUITE 106 MONTCLAIR, CA 91763 | AFLAC | $2K | $104 | $2K | 1.41% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP INC. | 18201 VON KARMAN AVENUE, SUITE 510 IRVINE, CA 92612 | AFLAC | $2K | $0 | $2K | 1.29% |
| CHRISTINA ANNE LEININGER3 Filed as: CHRISTINA LEINNGER | 8880 BENSON AVENUE, SUITE 106 MONTCLAIR, CA 91763 | AFLAC | $1K | $48 | $1K | 0.78% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | DENTAL HEALTH SERVICES | $11K | $0 | $11K | 8.72% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $10K | $4K | $15K | 14.21% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | $1K | $0 | $1K | 3.23% |
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 | 404 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 405 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA PHYSICIANS SERVICE | 403 | $2.0M |
| Dental | DENTAL HEALTH SERVICES | 458 | $132K |
| Vision | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | 480 | $36K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 300 | $103K |
| Short-term disability(2 contracts, 2 carriers) | AFLAC | 300 | $246K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 300 | $103K |
| Prescription drug | CALIFORNIA PHYSICIANS SERVICE | 403 | $2.0M |
| Other(3 contracts, 3 carriers) | AFLAC | 745 | $253K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 745 | — |
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."
No prospect flags tripped on this filing.