| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LEAVITT GROUP3 | 21820 BURBANK BOULEVARD, SUITE 300 WOODLAND HILLS, CA 91367 | HEALTH NET | $68K | — | $68K | 3.77% |
| LEAVITT GROUP3 | 21820 BURBANK BOULEVARD, SUITE 300 WOODLAND HILLS, CA 91367 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $45K | — | $45K | 5.70% |
| LEAVITT GROUP3 | 21820 BURBANK BOULEVARD, SUITE 300 WOODLAND HILLS, CA 91367 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $155 | $6K | 7.71% |
| VOLUNTARY BENEFIT ADVISORS3 Filed as: VOLUNTARY BENEFITS ADVISORS | 1936 EAST DEERE AVENUE, SUITE 215 SANTA ANA, CA 92705 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | — | $6K | 7.50% |
| LEAVITT GROUP3 | 21820 BURBANK BOULEVARD, SUITE 300 WOODLAND HILLS, CA 91367 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $11K | — | $11K | 18.84% |
| LEAVITT GROUP3 | 21820 BURBANK BOULEVARD WOODLAND HILLS, CA 91367 | WESTERN DENTAL SERVICES, INC. | $5K | — | $5K | 10.00% |
| LEAVITT GROUP3 | 21820 BURBANK BOULEVARD, SUITE 300 WOODLAND HILLS, CA 91367 | VISION SERVICE PLAN | $2K | — | $2K | 4.37% |
| LEAVITT GROUP3 | 21820 BURBANK BOULEVARD, SUITE 300 WOODLAND HILLS, AZ 85016 | PRINCIPAL LIFE INSURANCE COMPANY | $2K | — | $2K | 5.99% |
| HARTMAN, HOWARD, STANLEY3 | 22801 VENTURA BOULEVARD, SUITE 205 WOODLAND HILLS, CA 91364 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $45 | — | $45 | 3.74% |
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 | 303 | 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) | 303 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HEALTH NET | 229 | $2.6M |
| Dental(3 contracts, 3 carriers) | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | 454 | $872K |
| Vision | VISION SERVICE PLAN | 305 | $35K |
| Life insurance(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 303 | $136K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 303 | $60K |
| Long-term disability(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 303 | $62K |
| Prescription drug(2 contracts, 2 carriers) | HEALTH NET | 229 | $2.6M |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 303 | $136K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 454 | — |
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.