| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NEW CITY EXECUTIVE INSURANCE SERVIC3 Filed as: NEW CITY EXECUTIVE INS SERVICES | 550 WEST B STREET SAN DIEGO, CA 92101 | AETNA HEALTH, INC. | $55K | $0 | $55K | 2.36% |
| CLEVIDENCE INSURANCE SERVICES INC3 Filed as: CLEVIDENCE INSURANCE | 3000 WEST MACARTHUR BOULEVARD SUITE 320 SANTA ANA, CA 92704 | AETNA HEALTH, INC. | $37K | $0 | $37K | 1.61% |
| NEW CITY EXECUTIVE INSURANCE SERVIC3 Filed as: NEW CITY EXECUTIVE INS SERVICES | 615 C STREET, SUITE 300 SAN DIEGO, CA 92101 | HEALTH PLAN OF NEVADA | $8K | $0 | $8K | 3.51% |
| GCG FINANCIAL LLC3 Filed as: ALERA GROUP, INC. | 3000 WEST MACARTHUR BOULEVARD SUITE 320 SANTA ANA, CA 92704 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $12K | $17K | 8.57% |
| NEW CITY EXECUTIVE INSURANCE SERVIC3 Filed as: NEW CITY EXECUTIVE INS SERVICES | 615 C STREET, SUITE 300 SAN DIEGO, CA 92101 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $12K | $0 | $12K | 6.04% |
| GCG FINANCIAL LLC3 Filed as: ALERA GROUP, INC. | 3 PARKWAY NORTH BOULEVARD SUITE 500 DEERFIELD, IL 60015 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $2K | $2K | 0.90% |
| CLEVIDENCE INSURANCE SERVICES INC3 Filed as: CLEVIDENCE INSURANCE | 3000 WEST MACARTHUR BOULEVARD SUITE 320 SANTA ANA, CA 92704 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $0 | $2K | 0.83% |
| NEW CITY EXECUTIVE INSURANCE SERVIC3 Filed as: NEW CITY EXECUTIVE INS SERVICES | 550 WEST B STREET SAN DIEGO, CA 92101 | AETNA LIFE INSURANCE COMPANY | $2K | $0 | $2K | 2.28% |
| CLEVIDENCE INSURANCE SERVICES INC3 Filed as: CLEVIDENCE INSURANCE | 3000 WEST MACARTHUR BOULEVARD SUITE 320 SANTA ANA, CA 92704 | AETNA LIFE INSURANCE COMPANY | $1K | $256 | $1K | 1.86% |
| NEW CITY EXECUTIVE INSURANCE SERVIC3 Filed as: NEW CITY EXECUTIVE INS SVCS, LLC | 550 WEST B STREET, SUITE 400 SAN DIEGO, CA 92101 | SAFEGUARD HEALTH PLANS, INC. | $1K | $0 | $1K | 5.69% |
| CLEVIDENCE INSURANCE SERVICES INC3 Filed as: CLEVIDENCE INSURANCE | 3000 WEST MACARTHUR BOULEVARD SUITE 320 SANTA ANA, CA 92704 | SAFEGUARD HEALTH PLANS, INC. | $543 | $54 | $597 | 2.94% |
| GCG FINANCIAL LLC3 Filed as: ALERA GROUP, INC. | 310 WEST ESPLANADE DRIVE OXNARD, CA 93036 | SAFEGUARD HEALTH PLANS, INC. | $169 | $17 | $186 | 0.92% |
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 | 546 | 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) | 546 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | AETNA HEALTH, INC. | 391 | $2.6M |
| Dental | SAFEGUARD HEALTH PLANS, INC. | 180 | $20K |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 548 | $199K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 548 | $199K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 548 | $199K |
| Prescription drug(3 contracts, 3 carriers) | AETNA HEALTH, INC. | 391 | $2.6M |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 548 | $199K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 548 | — |
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.