| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LEAVITT GROUP3 Filed as: LEAVITT INSURANCE SERVICES OF LA | 21820 BURBANK BLVD., SUITE 300 WOODLAND HILLS, CA 91367 | BLUE CROSS OF CALIFORNIA | $178K | — | $178K | 5.50% |
| LEAVITT GROUP3 Filed as: LEAVITT INSURANCE SERVICES OF LA | 21820 BURBANK BLVD., SUITE 300 WOODLAND HILLS, CA 91367 | BLUECROSS BLUESHIELD OF TENNESSEE, INC. | $63K | — | $63K | 3.80% |
| LEAVITT GROUP3 Filed as: LEAVITT INSURANCE SERVICES OF LA | 21820 BURBANK BLVD., SUITE 300 WOODLAND HILLS, CA 91367 | PRINCIPAL LIFE INSURANCE COMPANY | $39K | — | $39K | 9.64% |
| LEAVITT GROUP3 Filed as: LEAVITT INSURANCE SERVICES OF LA | 21820 BURBANK BLVD., SUITE 300 WOODLAND HILLS, CA 91367 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $26K | — | $26K | 15.00% |
| VOLUNTARY BENEFIT ADVISORS3 | 2400 MAIN ST STE 200 IRVINE, CA 92614 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $50K | $6K | $56K | 34.06% |
| LEAVITT GROUP3 Filed as: LEAVITT INSURANCE SERVICES OF LA | 21820 BURBANK BLVD., SUITE 300 WOODLAND HILLS, CA 91367 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $50K | — | $50K | 30.37% |
| EMPLOYEE CHOICE SOLUTIONS3 Filed as: EMPLOYEE CHOICE SOLUTIONS INC. | 216 S 200W CEDAR CITY, UT 84720 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $2K | $2K | 1.37% |
| LEAVITT GROUP3 Filed as: LEAVITT INSURANCE SERVICES OF LA | 21820 BURBANK BLVD., SUITE 300 WOODLAND HILLS, CA 91367 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $16K | — | $16K | 10.00% |
| VOLUNTARY BENEFIT ADVISORS3 | 2400 MAIN ST STE 200 IRVINE, CA 92614 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $16K | — | $16K | 10.00% |
| LEAVITT GROUP3 Filed as: LEAVITT INSURANCE SERVICES OF LA | 21820 BURBANK BLVD., SUITE 300 WOODLAND HILLS, CA 91367 | VISION SERVICE PLAN | $5K | — | $5K | 10.00% |
| LEAVITT GROUP3 Filed as: LEAVITT INSURANCE SERVICES OF LA | 21820 BURBANK BLVD., SUITE 300 WOODLAND HILLS, CA 91367 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 14.87% |
| LEAVITT GROUP3 Filed as: LEAVITT INSURANCE SERVICES OF LA | 21820 BURBANK BLVD., SUITE 300 WOODLAND HILLS, CA 91367 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $644 | — | $644 | 7.51% |
| VOLUNTARY BENEFIT ADVISORS3 | 2400 MAIN STREET, SUITE 200 IRVINE, CA 92614 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $644 | — | $644 | 7.51% |
| LEAVITT GROUP3 Filed as: LEAVITT INSURANCE SERVICES OF LA | 21820 BURBANK BLVD., SUITE 300 WOODLAND HILLS, CA 91367 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 14.96% |
| VOLUNTARY BENEFIT ADVISORS3 Filed as: VOLUNTARY BENEFIT ADVISORS INC. | 2400 MAIN STREET, SUITE 200 IRVINE, CA 92614 | TRANSAMERICA LIFE INSURANCE CO. | $795 | — | $795 | 20.80% |
| LEAVITT GROUP3 Filed as: LEAVITT INSURANCE SERVICES OF LA | 21820 BURBANK BLVD., SUITE 300 WOODLAND HILLS, CA 91367 | TRANSAMERICA LIFE INSURANCE CO. | $296 | — | $296 | 7.74% |
| EMPLOYEE CHOICE SOLUTIONS3 Filed as: EMPLOYEE CHOICE SOLUTIONS INS. AGCY | 216 S. 200 W CEDAR CITY, UT 84720 | TRANSAMERICA LIFE INSURANCE CO. | $33 | — | $33 | 0.86% |
| HARTMAN, HOWARD, STANLEY3 | 4938 SHADY TRAIL STREET SIMI VALLEY, CA 93063 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $37 | — | $37 | 2.42% |
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 | 435 | 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) | 435 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 299 | $4.9M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 427 | $405K |
| Vision | VISION SERVICE PLAN | 422 | $51K |
| Life insurance(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 435 | $342K |
| Short-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 435 | $179K |
| Long-term disability(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 435 | $187K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 299 | $4.9M |
| Other(4 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 623 | $340K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 623 | — |
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.