| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | CALIFORNIA PHYSICIANS SERVICE | $0 | $133K | $133K | 3.15% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $24K | $0 | $24K | 10.00% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | METROPOLITAN LIFE INSURANCE COMPANY | $7K | $12K | $19K | 8.59% |
| PLANSOURCE BENEFITS ADMINISTRATION3 Filed as: PLANSOURCE BENEFITS ADMIN., INC. | 101 S GARLAND AVENUE, SUITE 203 ORLANDO, FL 32801 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $0 | $2K | 0.69% |
| MJ INSURANCE3 Filed as: KEVIN K. NANGIN AND VARIOUS AGENTS | 24781 PERSEUS COURT MISSION VIEJO, CA 92691 | AFLAC | $10K | $495 | $10K | 4.89% |
| CHRISTINA ANNE LEININGER3 | 27636 FALKIRK MISSION VIEJO, CA 92691 | AFLAC | $9K | $621 | $10K | 4.77% |
| KATHLEEN LEININGER INS SERVICES INC3 Filed as: KATHLEEN LEININGER INS. SVCS., INC. | 13655 NIMES COURT CHINO HILLS, CA 91709 | AFLAC | $5K | $14 | $5K | 2.29% |
| KEN MAJOR3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | AFLAC | $2K | $147 | $2K | 0.81% |
| MATTHEW EDWARD DAMIANO3 | 632 JUNIPERO AVENUE LONG BEACH, CA 90814 | AFLAC | $1K | $153 | $2K | 0.73% |
| SHANNON MARK DIXON3 | 348 12TH STREET, SUITE 3 SEAL BEACH, CA 90740 | AFLAC | $1K | $148 | $1K | 0.61% |
| STEPHANIE A REYNOSO3 Filed as: STEPHANIE A. REYNOSO | 21 CERVANTES NEWPORT BEACH, CA 92660 | AFLAC | $1K | $101 | $1K | 0.59% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $2K | $0 | $2K | 2.74% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $1K | $1K | $3K | 11.70% |
| PLANSOURCE BENEFITS ADMINISTRATION3 Filed as: PLANSOURCE BENEFITS ADMIN., INC. | 101 S GARLAND AVENUE, SUITE 203 ORLANDO, FL 32801 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $176 | $0 | $176 | 0.77% |
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 | 496 | 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) | 496 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA PHYSICIANS SERVICE | 605 | $4.2M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 415 | $243K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 697 | $56K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 544 | $237K |
| Short-term disability(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 544 | $444K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 544 | $237K |
| Prescription drug | CALIFORNIA PHYSICIANS SERVICE | 605 | $4.2M |
| Other(3 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 544 | $506K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 697 | — |
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.