| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LEAVITT GROUP3 Filed as: LEAVITT INS. SVCS. OF LOS ANGELES | 21820 BURBANK BOULEVARD SUITE 300 WOODLAND HILLS, CA 91367 | CALIFORNIA PHYSICIANS SERVICE | $96K | $122 | $96K | 2.27% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 100 SMITH RANCH ROAD, SUITE 112 SAN RAFAEL, CA 94903 | CALIFORNIA PHYSICIANS SERVICE | $5 | $0 | $5 | 0.00% |
| LEAVITT GROUP3 Filed as: LEAVITT INS. SVCS. OF LOS ANGELES | 21820 BURBANK BOULEVARD SUITE 300 WOODLAND HILLS, CA 91367 | KAISER FOUNDATION HEALTH PLAN INC | $65K | $0 | $65K | 4.32% |
| LEAVITT GROUP3 Filed as: LEAVITT INS. SVCS. OF LOS ANGELES | 21820 BURBANK BOULEVARD SUITE 300 WOODLAND HILLS, CA 91367 | HARTFORD LIFE AND ACCIDENT | $34K | $0 | $34K | 9.86% |
| LEAVITT GROUP3 | 216 SOUTH 200 WEST CEDAR CITY, UT 84720 | HARTFORD LIFE AND ACCIDENT | $0 | $6K | $6K | 1.77% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD 6TH FLOOR GLENDALE, CA 91203 | HARTFORD LIFE AND ACCIDENT | $3K | $0 | $3K | 0.92% |
| LEAVITT GROUP3 Filed as: LEAVITT INS. SVCS. OF LOS ANGELES | 21820 BURBANK BOULEVARD SUITE 300 WOODLAND HILLS, CA 91367 | METROPOLITAN LIFE INSURANCE COMPANY | $32K | $2K | $34K | 10.56% |
| LEAVITT GROUP3 Filed as: LEAVITT INS. SVCS. OF LOS ANGELES | 21820 BURBANK BOULEVARD, SUITE 300 SUITE 300 WOODLAND HILLS, CA 91367 | CONTINENTAL AMERICAN INSURANCE COMPANY | $16K | $0 | $16K | 10.50% |
| YOLANDA JOY RICHMAN3 Filed as: YOLANDA J. RICHMAN | 10000 NEVADA AVENUE CHATSWORTH, CA 91311 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | $0 | $1K | 0.91% |
| ADAM H MICHAELS3 Filed as: ADAM H. MICHAELS | UNKNOWN LOS ANGLES, CA 90049 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | $0 | $1K | 0.91% |
| CHRISTOPHER HAGER AND OTHER AGENTS3 | 12121 WILSHIRE BOULEVARD SUITE 1000 LOS ANGELES, CA 90025 | CONTINENTAL AMERICAN INSURANCE COMPANY | $704 | $0 | $704 | 0.47% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 18201 VON KARMAN, SUITE 200 IRVINE, CA 92612 | CONTINENTAL AMERICAN INSURANCE COMPANY | $537 | $0 | $537 | 0.36% |
| RENEE SUZANNE CORSO3 Filed as: RENEE S CORSO | 5805 SEPULVEDA BOULEVARD, SUITE 740 SHERMAN OAKS, CA 91411 | CONTINENTAL AMERICAN INSURANCE COMPANY | $531 | $0 | $531 | 0.35% |
| RICHARD J KUNZ3 Filed as: RICHARD J. KUNZ | 351 CALIFORNIA STREET, SUITE 450 SAN FRANCISCO, CA 94104 | CONTINENTAL AMERICAN INSURANCE COMPANY | $372 | $0 | $372 | 0.25% |
| LEAVITT GROUP3 Filed as: LEAVITT INS. SVCS. OF LOS ANGELES | 21820 BURBANK BOULEVARD, SUITE 300 SUITE 300 WOODLAND HILLS, CA 91367 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $8K | $438 | $9K | 10.60% |
| LEAVITT GROUP3 Filed as: LEAVITT INS. SVCS. OF LOS ANGELES | 21820 BURBANK BOULEVARD SUITE 300 WOODLAND HILLS, CA 91367 | VISION SERVICE PLAN | $4K | $0 | $4K | 4.57% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, SUITE 1000 ROLLING MEADOWS, IL 60008 | VISION SERVICE PLAN | $347 | $0 | $347 | 0.43% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 11060 WHITE ROCK ROAD SUITE 160 RANCHO CORDOVA, CA 95670 | LANDMARK HEALTHPLAN | $0 | $1K | $1K | 10.00% |
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 | 692 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 696 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 778 | $5.8M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 731 | $400K |
| Vision | VISION SERVICE PLAN | 537 | $80K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 692 | $346K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 692 | $346K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 692 | $346K |
| Prescription drug | CALIFORNIA PHYSICIANS SERVICE | 778 | $4.2M |
| Other(3 contracts, 3 carriers) | HARTFORD LIFE AND ACCIDENT | 692 | $510K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 778 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.