| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LEAVITT GROUP3 Filed as: LEAVITT CENTRAL COAST INS SVCS INC | 950 EAST BLANCO ROAD, SUITE 103 SALINAS, CA 93901 | KAISER FOUNDATION HEALTH PLAN INC | $30K | $0 | $30K | 3.35% |
| MJ INSURANCE3 Filed as: DONNA DEVINY AND VARIOUS AGENTS | 11148 NOATAK RIVER COURT RANCHO CORDOVA, CA 95670 | AFLAC | $2K | $0 | $2K | 3.45% |
| ALAINE S. VANNESS3 | 1217 SOUTH SOUTH STREET LODI, CA 95240 | AFLAC | $1K | $0 | $1K | 2.47% |
| NEAL E. DAILY3 | 1852 WEST 11TH STREET, SUITE 310 TRACY, CA 95376 | AFLAC | $509 | $0 | $509 | 1.17% |
| LEAVITT GROUP3 Filed as: LEAVITT CENTRAL COAST INS SVCS INC | 950 EAST BLANCO ROAD, SUITE 103 SALINAS, CA 93901 | AFLAC | $459 | $0 | $459 | 1.05% |
| DAVID B. KITCHEN3 | 5230 HARTER LANE LA CANADA FLINTRIDGE, CA 91011 | AFLAC | $390 | $0 | $390 | 0.89% |
| SERAPIO M. NAMBO3 | 2175 57TH AVENUE SACRAMENTO, CA 95822 | AFLAC | $322 | $0 | $322 | 0.74% |
| FRANCISCO MALDONADO3 | 1242 TULLOCH DRIVE TRACY, CA 95304 | AFLAC | $214 | $0 | $214 | 0.49% |
| LEAVITT GROUP3 Filed as: LEAVITT CENTRAL COAST INS SVCS INC | 950 EAST BLANCO ROAD, SUITE 103 SALINAS, CA 93901 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $1K | $5K | 13.77% |
| LEAVITT GROUP3 Filed as: LEAVITT CENTRAL COAST INS SVCS INC | 2345 KING AVENUE WEST, SUITE E BILLINGS, MT 59102 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $110 | $110 | 0.31% |
| LEAVITT GROUP3 Filed as: LEAVITT CENTRAL COAST INS SVCS INC | 950 EAST BLANCO ROAD, SUITE 103 SALINAS, CA 93901 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $2K | $0 | $2K | 12.99% |
| GARY E. HUETTINGER4 | 2927 CORPUS CHRISTI STREET SIMI VALLEY, CA 93063 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $124 | $0 | $124 | 4.70% |
| JULIE W JEFFRIES4 Filed as: JULIE W. JEFFRIES | 501 GIBSON DRIVE, SUITE 1211 ROSEVILLE, CA 95678 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $112 | $0 | $112 | 4.25% |
| MARK MCDONALD4 Filed as: MARK D. MCDONALD | 1365 SEACOAST DRIVE, SUITE M IMPERIAL BEACH, CA 91932 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $34 | $0 | $34 | 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 | 163 | 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. |
| Total participants (= "Plan participants" tile) | 166 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 193 | $885K |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 217 | $12K |
| Life insurance(2 contracts, 2 carriers) | AFLAC | 163 | $79K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 193 | $885K |
| Other(3 contracts, 3 carriers) | AFLAC | 163 | $81K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 217 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.