| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE SUITE 1200 IRVINE, CA 92612 | AETNA LIFE INSURANCE CO. | $66K | — | $66K | 2.76% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 1100 LARKSPUR LANDING CIR STE 180 LARKSPUR, CA 94939 | AETNA LIFE INSURANCE CO. | $23K | — | $23K | 0.95% |
| LEAVITT GROUP3 Filed as: LEAVITT INSURANCE SERVICES OF LA | 21820 BURBANK BLVD, STE 300 WOODLAND HILLS, CA 91367 | AETNA LIFE INSURANCE CO. | $21K | — | $21K | 0.88% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DR STE 1200 IRVINE, CA 926120304 | KAISER FOUNDATION HEALTH PLAN INC. | $39K | $38 | $39K | 5.75% |
| LEAVITT GROUP3 Filed as: LEAVITT INSURANCE SERVICES OF LA | 21820 BURBANK BLVD, STE 300 WOODLAND HILLS, CA 91367 | KAISER FOUNDATION HEALTH PLAN INC. | $7K | — | $7K | 1.04% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DRIVE SUITE 1200 IRVINE, CA 92612 | AETNA HEALTH, INC | $13K | — | $13K | 2.25% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 1100 LARKSPUR LANDING CIR STE 180 LARKSPUR, CA 94939 | AETNA HEALTH, INC | $5K | — | $5K | 0.82% |
| LEAVITT GROUP3 Filed as: LEAVITT INSURANCE SERVICES OF LA | 21820 BURBANK BLVD, STE 300 WOODLAND HILLS, CA 91367 | AETNA HEALTH, INC | $4K | — | $4K | 0.74% |
| BURNHAM BENEFITS INSURANCE SERVICES3 | 2211 MICHELSON DR STE 1200 IRVINE, CA 92612 | GUARDIAN | $23K | $3K | $26K | 7.69% |
| LEAVITT GROUP3 Filed as: LEAVITT INSURANCE SERVICES OF LA | 21820 BURBANK BLVD, STE 300 WOODLAND HILLS, CA 91367 | GUARDIAN | $4K | — | $4K | 1.29% |
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 | 435 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 438 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA LIFE INSURANCE CO. | 715 | $3.1M |
| Dental | GUARDIAN | 418 | $337K |
| Vision | AETNA LIFE INSURANCE CO. | 715 | $2.4M |
| Life insurance | AETNA LIFE INSURANCE CO. | 715 | $2.4M |
| Short-term disability | AETNA LIFE INSURANCE CO. | 715 | $2.4M |
| Long-term disability | AETNA LIFE INSURANCE CO. | 715 | $2.4M |
| Other | AETNA LIFE INSURANCE CO. | 715 | $2.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 715 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.