| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LEAVITT GROUP3 Filed as: LEAVITT INSURANCE SERVICES OF LA | 21820 BURBANK BLVD., STE 300 WOODLAND HILLS, CA 91367 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $33K | $3K | $36K | 21.28% |
| LEAVITT GROUP3 | 21820 BURBANK BLVD., STE 300 WOODLAND HILLS, CA 91367 | UNITED CONCORDIA INSURANCE COMPANY | $8K | — | $8K | 10.01% |
| LEAVITT GROUP3 Filed as: LEAVITT INNSURANCE SERVICES OF LA | 21820 BURBANK BLVD., STE 300 WOODLAND HILLS, CA 91367 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 7.50% |
| VOLUNTARY BENEFIT ADVISORS3 | 2400 MAIN ST. STE 200 IRVINE, CA 92614 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 7.50% |
| LEAVITT GROUP3 Filed as: LEAVITT INSURANCE SERVICES OF LA | 21820 BURBANK BLVD., STE 300 WOODLAND HILLS, CA 91367 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 7.50% |
| VOLUNTARY BENEFIT ADVISORS3 | 2400 MAIN ST. STE. 200 IRVINE, CA 92614 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 7.50% |
| VOLUNTARY BENEFIT ADVISORS3 | 2400 MAIN STREET, STE 200 IRVINE, CA 92614 | TRUSTMARK INSURANCE COMPANY | $1K | — | $1K | 6.32% |
| LEAVITT GROUP3 Filed as: LEAVITT INSURANCE SERVICES | 21820 BURBANK BLVD., STE 300 WOODLAND HILLS, CA 91367 | TRUSTMARK INSURANCE COMPANY | $494 | — | $494 | 2.97% |
| VOLUNTARY BENEFIT ADVISORS3 | 2400 MAIN STREET, STE 200 IRVINE, CA 92614 | TRUSTMARK INSURANCE COMPANY | $2K | — | $2K | 12.84% |
| LEAVITT GROUP3 Filed as: LEAVITT INSURANCE SERVICES | 21820 BURBANK BLVD., STE 300 WOODLAND HILLS, CA 91367 | TRUSTMARK INSURANCE COMPANY | $1K | — | $1K | 6.09% |
| LEAVITT GROUP3 Filed as: LEAVITT INSURANCE SERVICES | 21820 BURBANK BLVD. STE 300 WOODLAND HILLS, CA 91367 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $966 | — | $966 | 10.00% |
| LEAVITT GROUP3 Filed as: LEAVITT INSURANCE SERVICES | 21820 BURBANK BLVD., STE 300 WOODLAND HILLS, CA 91367 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $161 | — | $161 | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO. EIN 59-1031071 SERVICE PROVIDER | Other fees Service code 99 | — | $57K |
| CIGNA HEALTH & LIFE INSURANCE CO. | Other services; Non-monetary compensation; Claims processing; Direct payment from the plan; Float revenue; Named fiduciary; Participant communication; Contract Administrator Service code 12 | — | $0 |
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 | 142 | 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) | 142 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 138 | $172K |
| Dental | UNITED CONCORDIA INSURANCE COMPANY | 142 | $85K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 138 | $172K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 138 | $10K |
| Other(5 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 138 | $81K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 142 | — |
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.