| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | KAISER FOUNDATION HEALTH PLAN, INC. | $104K | $0 | $104K | 3.00% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | PRINCIPAL LIFE INSURANCE COMPANY | $51K | $5K | $56K | 8.77% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $40K | $0 | $40K | 10.00% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | $12K | — | $12K | 9.90% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE, SUITE 1200 IRVINE, CA 92612 | CALIFORNIA DENTAL NETWORK, INC. | $4K | $0 | $4K | 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 | 1,101 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,106 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN, INC. | 560 | $3.5M |
| Dental(3 contracts, 3 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 1,435 | $694K |
| Vision | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. | 1,630 | $125K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,101 | $398K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,101 | $398K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,101 | $398K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN, INC. | 560 | $3.5M |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,101 | $398K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,630 | — |
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.