| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS SVCS INC | 10474 SANTA MONICA BLVD SUITE 200 LOS ANGELES, CA 90025 | CALIFORNIA PHYSICIANS' SERVICE | $79K | $83 | $79K | 4.16% |
| LEAVITT GROUP3 Filed as: LEAVITT OF SOUTHERN CALIFORNIA | 3965 OLD WAVERLY CIRCLE CORONA, CA 92883 | CALIFORNIA PHYSICIANS' SERVICE | $16K | $2K | $18K | 0.95% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS SERVICES, INC. | 160 W SANTA CLARA ST STE 450 SAN JOSE, CA 95113 | KAISER FOUNDATION HEALTH PLAN INC | $9K | — | $9K | 3.70% |
| LEAVITT GROUP3 Filed as: LEAVITT BENEFIT INS SERVICE OF S CA | 1820 E 1ST ST STE 500 SANTA ANA, CA 92705 | KAISER FOUNDATION HEALTH PLAN INC | $2K | — | $2K | 0.85% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS SERVICES, INC. | 2301 DUPORT DR 2ND FLOOR IRVINE, CA 92612 | PREMIER ACCESS INSURANCE COMPANY | $3K | — | $3K | 2.49% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE | 32110 AGOURA RD WESTLAKE VILLAGE, CA 91361 | PREMIER ACCESS INSURANCE COMPANY | $2K | — | $2K | 1.84% |
| LEAVITT GROUP3 Filed as: LEAVITT INS SERVICES OF S CA,INC. | 1820 E FIRST ST STE 500 SANTA ANA, CA 92705 | PREMIER ACCESS INSURANCE COMPANY | $853 | — | $853 | 0.83% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INS SERV-IRVINE, CA | P.O.BOX 632886 CINCINNATI, OH 45263 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $2K | — | $2K | 6.43% |
| LEAVITT GROUP3 | 1820 EAST 1ST STREET #500 SANTA ANA, CA 92705 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $746 | — | $746 | 2.37% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 700 W 47TH ST STE 1100 KANSAS CITY, OH 64112 | UNION SECURITY INSURANCE COMPANY | $3K | $938 | $4K | 17.96% |
| LEAVITT GROUP3 Filed as: LEAVITT INS SERVICES OF S CA INC | 1820 E FIRST ST STE 500 SANTA ANA, CA 92705 | UNION SECURITY INSURANCE COMPANY | $286 | — | $286 | 1.28% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SERV | 700 W 47TH ST STE 1100 KANSAS CITY, OH 64112 | UNION SECURITY INSURANCE COMPANY | $755 | $350 | $1K | 13.32% |
| LEAVITT GROUP3 Filed as: LEAVITT INS SERVICES OF S CA INC | 1820 E FIRST ST STE 500 SANTA ANA, CA 92705 | UNION SECURITY INSURANCE COMPANY | $70 | — | $70 | 0.84% |
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 | 181 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 181 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA PHYSICIANS' SERVICE | 427 | $1.9M |
| Dental | PREMIER ACCESS INSURANCE COMPANY | 582 | $103K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 592 | $31K |
| Life insurance | UNION SECURITY INSURANCE COMPANY | 181 | $8K |
| Short-term disability | UNION SECURITY INSURANCE COMPANY | 100 | $22K |
| Prescription drug | CALIFORNIA PHYSICIANS' SERVICE | 427 | $1.9M |
| Other | UNION SECURITY INSURANCE COMPANY | 181 | $8K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 592 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.