| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSURANCE AGENCY LTD3 Filed as: INFINITY ASSURANCE GROUP | 12 MAUCHLY, BLDG. I IRVINE, CA 92618 | BLUE CROSS OF CALIFORNIA | $214K | — | $214K | 5.39% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA | 1950 W. CORPORATE WAY ANAHEIM, CA 92801 | BLUE CROSS OF CALIFORNIA | -$2K | — | -$2K | -0.05% |
| TCS INSURANCE AGENCY INC3 Filed as: TCS INSURANCE AGENCY | 101 LARKSPUR LANDING CIRCLE LARKSPUR, CA 94939 | SUN LIFE ASSURANCE COMPANY OF CANADA | $54K | — | $54K | 9.60% |
| HARRY LEVITT3 | 1600 CAPRI DRIVE PACIFIC PALISADES, CA 90272 | SUN LIFE ASSURANCE COMPANY OF CANADA | $23K | — | $23K | 4.12% |
| TCS INSURANCE AGENCY INC3 Filed as: TCS INSURANCE AGENCY | 101 LARKSPUR LANDING LARKSPUR, CA 94939 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $27K | $20K | $48K | 16.31% |
| NORMAN LEVITT3 | 1600 CAPRI DRIVE PACIFIC PALISADES, CA 90272 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $5K | $2K | $7K | 2.28% |
| MULLINTBG INSURANCE AGENCY3 | 33174 COLLECTION CENTER DRIVE CHICAGO, IL 60673 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $5K | $694 | $5K | 1.78% |
| M FINANCIAL HOLDINGS INC3 Filed as: M FINANCIAL HOLDINGS | 1125 NW COUCH STREET PORTLAND, OR 97209 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $3K | $3K | 1.09% |
| KAREN G. HAIGH3 Filed as: KAREN HAIGH | 6011 COUNTRY VIEW DRIVE YORBA LINDA, CA 92886 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $425 | $230 | $655 | 0.22% |
| AON CONSULTING INC3 Filed as: AON CONSULTING | 5600 WEST 83RD STREET BLOOMINGTON, MN 55437 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $196 | — | $196 | 0.07% |
| MICHAEL RUBAUM HARRIS3 | 3639 LIVINGSON ROAD CENTRAL POINT, OR 97502 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $56 | — | $56 | 0.02% |
| ASSURANCE AGENCY LTD3 Filed as: INFINITY ASSURANCE GROUP | 12 MAUCHLY, BLDG. I IRVINE, CA 92618 | PRINCIPAL LIFE INSURANCE COMPANY | $8K | -$53 | $8K | 3.68% |
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 | 202 | Currently employed and enrolled or eligible. |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 202 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 193 | $4.0M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 180 | $228K |
| Vision | BLUE CROSS OF CALIFORNIA | 193 | $4.0M |
| Life insurance | BLUE CROSS OF CALIFORNIA | 193 | $4.0M |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 202 | $558K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 202 | $558K |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 193 | $4.0M |
| Other(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 193 | $4.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 202 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.