| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THOMAS MEANS3 | 885 PATRIOT DRIVE MOORPARK, CA 93021 | CALIFORNIA PHYSICIANS SERVICE | — | $153K | $153K | 5.71% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICES | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 91361 | CALIFORNIA PHYSICIANS SERVICE | — | $57K | $57K | 2.12% |
| TCS INSURANCE AGENCY INC3 Filed as: TCS INSURANCE AGENCY INC. | 100 SMITH RANCH ROAD SAN RAFAEL, CA 94903 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $46K | — | $46K | 9.00% |
| HARRY LEVITT3 | 1600 CAPRI DRIVE PACIFIC PALISADES, CA 90272 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $20K | — | $20K | 3.86% |
| MGIS5 | 111 SOUTH MAIN STEET SALT LAKE CITY, UT 84111 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $184 | $184 | 0.04% |
| TCS INSURANCE AGENCY INC3 Filed as: TCS INSURANCE AGENCY INC. | 100 SMITH RANCH ROAD SAN RAFAEL, CA 94903 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $23K | $19K | $43K | 20.91% |
| HARRY LEVITT3 | 1600 CAPRI DRIVE PACIFIC PALISADES, CA 90272 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $8K | $1K | $10K | 4.81% |
| M FINANCIAL HOLDINGS INC3 Filed as: M FINANCIAL HOLDINGS | 1125 NW COUCH STREET PORTLAND, OR 97209 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $5K | $5K | 2.32% |
| HAIGH, KAREN GOSS3 | 6011 COUNTRY VIEW DRIVE YORBA LINDA, CA 92886 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $35 | $35 | 0.02% |
| THOMAS MEANS3 | 885 PATRIOT DRIVE MOORPARK, CA 93021 | AMERITAS LIFE INSURANCE CORP. | $25K | — | $25K | 15.00% |
| THOMAS MEANS3 | 885 PATRIOT DRIVE MOORPARK, CA 93021 | BLUE SHIELD OF CALIFORNIA LIFE & HEALTH INSURANCE COMPANY | $814 | — | $814 | 10.00% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICES | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 91361 | BLUE SHIELD OF CALIFORNIA LIFE & HEALTH INSURANCE COMPANY | — | $163 | $163 | 2.00% |
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 | 121 | 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) | 122 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA PHYSICIANS SERVICE | 114 | $2.7M |
| Dental | AMERITAS LIFE INSURANCE CORP. | 112 | $169K |
| Vision | AMERITAS LIFE INSURANCE CORP. | 112 | $169K |
| Life insurance(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 124 | $519K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 121 | $511K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 121 | $511K |
| Prescription drug | CALIFORNIA PHYSICIANS SERVICE | 114 | $2.7M |
| Other(3 contracts, 3 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 125 | $722K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 125 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.