| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LEAVITT GROUP3 | 21650 OXNARD STREET, SUITE 1825 WOODLAND HILLS, CA 91367 | BLUE CROSS OF CALIFORNIA | $58K | — | $58K | 4.59% |
| LEAVITT GROUP3 | 21650 OXNARD STREET, SUITE 1825 WOODLAND HILLS, CA 91367 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $4K | — | $4K | 5.00% |
| VOLUNTARY BENEFIT ADVISORS3 | 1936 EAST DEERE AVENUE, SUITE 215 SANTA ANA, CA 92705 | KANAWHA INSURANCE COMPANY | $2K | — | $2K | 4.92% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 21700 OXNARD STREET, SUITE 1200 WOODLAND HILLS, CA 91367 | KANAWHA INSURANCE COMPANY | $942 | — | $942 | 2.11% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 21600 OXNARD STREET, 8TH FLOOR WOODLAND HILLS, CA 91367 | KANAWHA INSURANCE COMPANY | $668 | — | $668 | 1.49% |
| LEAVITT GROUP3 | 21650 OXNARD STREET, SUITE 1825 WOODLAND HILLS, CA 91367 | KANAWHA INSURANCE COMPANY | $40 | — | $40 | 0.09% |
| LEAVITT GROUP3 | 21650 OXNARD STREET, SUITE 1825 WOODLAND HILLS, CA 91367 | UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. | $2K | — | $2K | 9.00% |
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 | 173 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 174 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 273 | $1.3M |
| Dental(2 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 126 | $98K |
| Vision | BLUE CROSS OF CALIFORNIA | 273 | $1.3M |
| Life insurance(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 273 | $1.3M |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 273 | $1.3M |
| Other(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 273 | $1.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 273 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.