| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LEAVITT GROUP3 Filed as: LEAVITT INSURANCE SERVICES OF LA | 21820 N. BURBANK BLVD., NORTH BUILDING, STE. 300 WOODLAND HILLS, CA 91367 | BLUE CROSS OF CALIFORNIA | $28K | — | $28K | 5.54% |
| LEAVITT GROUP3 Filed as: LEAVITT INSURANCE SERVICES | 21820 BURBANK BLVD., NORTH BUILDING, STE. 300 WOODLAND HILLS, CA 91367 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $9K | — | $9K | 10.00% |
| PACIFIC ADVISOR LLC3 | 333 INDIAN HILL BLVD. CLAREMONT, CA 91711 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $655 | — | $655 | 0.75% |
| LEAVITT GROUP3 Filed as: LEAVITT INSURANCE SERVICES OF LA | 21820 N. BURBANK BLVD., NORTH BUILDING, STE. 300 WOODLAND HILLS, CA 91367 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $1K | — | $1K | 5.54% |
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 | 257 | 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) | 257 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 71 | $501K |
| Dental(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 132 | $588K |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 257 | $22K |
| Life insurance | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 257 | $22K |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 71 | $501K |
| Other | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 257 | $22K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 257 | — |
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.