| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THOMAS MEANS3 | 885 PATRIOT DRIVE MOORPARK, CA 93021 | CALIFORNIA PHYSICIANS SERVICE | — | $161K | $161K | 6.39% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICES | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 91361 | CALIFORNIA PHYSICIANS SERVICE | — | $54K | $54K | 2.13% |
| TCS INSURANCE AGENCY INC3 Filed as: TCS INSURANCE AGENCY INC. | 100 SMITH RANCH ROAD SAN RAFAEL, CA 94903 | SUN LIFE ASSURANCE COMPANY OF CANADA | $28K | — | $28K | 8.99% |
| HARRY LEVITT3 | 1600 CAPRI DRIVE PACIFIC PALISADES, CA 90272 | SUN LIFE ASSURANCE COMPANY OF CANADA | $12K | — | $12K | 3.85% |
| MGIS5 | 111 SOUTH MAIN STEET SALT LAKE CITY, UT 94111 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $120 | $120 | 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 | $22K | $12K | $34K | 17.83% |
| HARRY LEVITT3 | 1600 CAPRI DRIVE PACIFIC PALISADES, CA 90272 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $8K | $1K | $9K | 4.91% |
| M FINANCIAL HOLDINGS INC3 Filed as: M FINANCIAL HOLDINGS | 1125 NW COUCH STREET PORTLAND, OR 97209 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $4K | $4K | 2.17% |
| HAIGH, KAREN GOSS3 | 6011 COUNTRY VIEW DRIVE YORBA LINDA, CA 92886 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $57 | $9 | $66 | 0.03% |
| TCS INSURANCE AGENCY INC3 Filed as: TCS INSURANCE AGENCY INC. | 100 SMITH RANCH ROAD SAN RAFAEL, CA 94903 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $11K | — | $11K | 8.99% |
| HARRY LEVITT3 | 1600 CAPRI DRIVE PACIFIC PALISADES, CA 90272 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $5K | — | $5K | 3.86% |
| MGIS5 | 111 SOUTH MAIN STEET SALT LAKE CITY, UT 84111 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $56 | $56 | 0.05% |
| THOMAS MEANS3 | 885 PATRIOT DRIVE MOORPARK, CA 93021 | AMERITAS LIFE INSURANCE CORP. | $3K | — | $3K | 15.00% |
| THOMAS MEANS3 | 885 PATRIOT DRIVE MOORPARK, CA 93021 | BLUE SHIELD OF CALIFORNIA LIFE & HEALTH INSURANCE COMPANY | $759 | — | $759 | 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 | — | $152 | $152 | 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 | 128 | 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) | 129 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA PHYSICIANS SERVICE | 114 | $2.5M |
| Dental | AMERITAS LIFE INSURANCE CORP. | 112 | $20K |
| Vision | AMERITAS LIFE INSURANCE CORP. | 112 | $20K |
| Life insurance(3 contracts, 3 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 130 | $438K |
| Short-term disability(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 128 | $430K |
| Long-term disability(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 128 | $430K |
| Prescription drug | CALIFORNIA PHYSICIANS SERVICE | 114 | $2.5M |
| Other(4 contracts, 4 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 130 | $630K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 130 | — |
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.