| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 160 WEST SANTA CLARA STREET SUITE 300 SAN JOSE, CA 91367 | CALIFORNIA PHYSICIANS SERVICE | $194K | $0 | $194K | 3.07% |
| LEAVITT GROUP3 Filed as: LEAVITT INSURANCE SERVICES OF LA | 21820 BURBANK BOULEVARD, SUITE 300 WOODLAND HILLS, CA 91367 | CALIFORNIA PHYSICIANS SERVICE | $59K | $77 | $59K | 0.93% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD SUITE 600 GLENDALE, CA 91203 | KAISER FOUNDATION HEALTH PLAN INC | $43K | $0 | $43K | 2.67% |
| LEAVITT GROUP3 Filed as: LEAVITT INSURANCE SERVICES OF LA | 21820 BURBANK BOULEVARD, SUITE 300 WOODLAND HILLS, CA 91367 | KAISER FOUNDATION HEALTH PLAN INC | $21K | $0 | $21K | 1.32% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD SUITE 600 GLENDALE, CA 91203 | HARTFORD LIFE AND ACCIDENT | $19K | $0 | $19K | 9.30% |
| LEAVITT GROUP3 | 216 SOUTH 200 WEST CEDAR CITY, UT 84720 | HARTFORD LIFE AND ACCIDENT | $0 | $5K | $5K | 2.37% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE, 21ST FLOOR ITASCA, IL 60143 | HARTFORD LIFE AND ACCIDENT | $0 | $1K | $1K | 0.64% |
| LEAVITT GROUP3 | 21820 BURBANK BOULEVARD, SUITE 300 WOODLAND HILLS, CA 91367 | HARTFORD LIFE AND ACCIDENT | $92 | $0 | $92 | 0.04% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD 6TH FLOOR GLENDALE, CA 91203 | METROPOLITAN LIFE INSURANCE COMPANY | $23K | $64 | $23K | 11.42% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $3K | $3K | 1.57% |
| LEAVITT GROUP3 | 21820 BURBANK BOULEVARD, SUITE 300 WOODLAND HILLS, CA 91367 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $63 | $63 | 0.03% |
| LEAVITT GROUP3 | 21820 BURBANK BOULEVARD, SUITE 300 WOODLAND HILLS, CA 91367 | CONTINENTAL AMERICAN INSURANCE COMPANY | $8K | $0 | $8K | 8.10% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 18201 VON KARMAN, SUITE 200 IRVINE, CA 92612 | CONTINENTAL AMERICAN INSURANCE COMPANY | $5K | $0 | $5K | 4.98% |
| YOLANDA JOY RICHMAN3 Filed as: YOLANDA J. RICHMAN | 10000 NEVADA AVENUE CHATSWORTH, CA 91311 | CONTINENTAL AMERICAN INSURANCE COMPANY | $841 | $0 | $841 | 0.80% |
| ADAM H MICHAELS3 Filed as: ADAM H. MICHAELS | 2922 CORDA LANE LOS ANGELES, CA 90049 | CONTINENTAL AMERICAN INSURANCE COMPANY | $810 | $0 | $810 | 0.77% |
| JOSEPH A BUZZELLO3 Filed as: JOSEPH A. BUZZELLO AND OTHER AGENTS | 9018 BALBOA BOULEVARD, SUITE 254 NORTHRIDGE, CA 91325 | CONTINENTAL AMERICAN INSURANCE COMPANY | $521 | $0 | $521 | 0.50% |
| RENEE SUZANNE CORSO3 Filed as: RENEE S. CORSO | 5805 SEPULVED A BOULEVARD SUITE 740 SHERMAN OAKS, CA 91311 | CONTINENTAL AMERICAN INSURANCE COMPANY | $426 | $0 | $426 | 0.41% |
| RICHARD J KUNZ3 Filed as: RICHARD J. KUNZ | 1155 NORTH MICHIGAN AVENUE PASADENA, CA 91104 | CONTINENTAL AMERICAN INSURANCE COMPANY | $220 | $0 | $220 | 0.21% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, SUITE 1000 ROLLING MEADOWS, IL 60008 | VISION SERVICE PLAN | $4K | $0 | $4K | 5.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD 6TH FLOOR GLENDALE, CA 91203 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA COPORATION | $5K | $0 | $5K | 11.39% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA COPORATION | $0 | $717 | $717 | 1.56% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 11060 WHITE ROCK ROAD, SUITE 160 RANCHO CORDOVA, CA 95670 | LANDMARK HEALTHPLAN | $1K | $0 | $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 | 685 | 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) | 685 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 796 | $7.9M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 685 | $244K |
| Vision | VISION SERVICE PLAN | 546 | $84K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 685 | $207K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 685 | $207K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 685 | $207K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 796 | $7.9M |
| Other(3 contracts, 3 carriers) | HARTFORD LIFE AND ACCIDENT | 685 | $325K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 796 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.