| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THOMAS MEANS3 | 4607 LAKEVIEW CANYON ROAD WESTLAKE VILLAGE, CA 91361 | CALIFORNIA PHYSICIANS SERVICE | $23 | $25K | $25K | 6.38% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICES | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 91361 | CALIFORNIA PHYSICIANS SERVICE | — | $8K | $8K | 2.13% |
| TCS INSURANCE AGENCY INC3 Filed as: TCS INSURANCE AGENCY INC. | 101 LARKSPUR LANDING LARKSPUR, CA 94939 | SUN LIFE ASSURANCE COMPANY OF CANADA | $7K | — | $7K | 9.03% |
| HARRY LEVITT3 | 1600 CAPRI DRIVE PACIFIC PALISADES, CA 90272 | SUN LIFE ASSURANCE COMPANY OF CANADA | $3K | — | $3K | 3.87% |
| MGIS5 | 111 SOUTH MAIN STEET SALT LAKE CITY, UT 94111 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $30 | $30 | 0.04% |
| TCS INSURANCE AGENCY INC3 Filed as: TCS INSURANCE AGENCY INC. | 101 LARKSPUR LANDING LARKSPUR, CA 94939 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $770 | $5K | 14.31% |
| HARRY LEVITT3 | 1600 CAPRI DRIVE PACIFIC PALISADES, CA 90272 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $300 | $2K | 5.61% |
| M FINANCIAL HOLDINGS INC3 Filed as: M FINANCIAL | 1125 NW COUCH STREET, SUITE 900 PORTLAND, OR 97209 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $1K | $1K | 4.32% |
| THOMAS MEANS3 | 4607 LAKEVIEW CANYON ROAD WESTLAKE VILLAGE, CA 91361 | AMERITAS LIFE INSURANCE CORP. | $3K | — | $3K | 15.00% |
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 | 125 | 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) | 126 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA PHYSICIANS SERVICE | 111 | $387K |
| Dental | AMERITAS LIFE INSURANCE CORP. | 112 | $22K |
| Vision | AMERITAS LIFE INSURANCE CORP. | 112 | $22K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 125 | $79K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 125 | $79K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 125 | $79K |
| Prescription drug | CALIFORNIA PHYSICIANS SERVICE | 111 | $387K |
| Other(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 125 | $113K |
| 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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.