| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LEAVITT GROUP3 Filed as: LEAVITT INS. AGENCY OF SAN DIEGO | 3363 NOBEL DRIVE, SUITE 100 SAN DIEGO, CA 92122 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $40K | — | $40K | 5.54% |
| LEAVITT GROUP3 Filed as: LEAVITT INS. AGENCY OF SAN DIEGO | 3636 NOBEL DRIVE, SUITE 100 SAN DIEGO, CA 92122 | KAISER FOUNDATION HEALTH PLAN INC. | $17K | — | $17K | 4.92% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS. SVCS. | P.O. BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN INC. | — | $750 | $750 | 0.22% |
| CALIFORNIA INSURANCE ADVOCATES INC3 | 41960 AVENIDA DE ANITA TEMECULA, CA 92592 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $816 | $4K | 11.90% |
| DEL DOWNEY3 | 41960 AVENIDA DE ANITA TEMECULA, CA 92592 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $69 | $3K | 9.62% |
| LEAVITT GROUP3 Filed as: LEAVITT GROUP BENEFIT SERVICES INC | 7881 WEST CHARLESTON BLVD. LAS VEGAS, NV 89117 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $141 | $3K | 8.87% |
| ANTONIA DAVILA3 Filed as: ANTONIA MARIA HOLDEN | 8932 CREEKFORD ST LAKESIDE, CA 92040 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $223 | $2K | 6.34% |
| ANDREA MARIE TIERCE3 | 2204 PLEASANTWOOD LN ESCONDIDO, CA 92026 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $751 | $2K | 6.03% |
| STACI MARIE FERRARIS3 | 28912 GLEN ROCK PLACE HIGHLAND, CA 92346 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $212 | $1K | 3.92% |
| MARTHA ANGELICA HILL ESTRADA3 | 3196 HAWTHORN ST SAN DIEGO, CA 92104 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $156 | $1K | 3.51% |
| SAMAR BREIK ALBIN3 | 41572 VALOR DR MURRIETA, CA 92562 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $807 | $208 | $1K | 3.07% |
| LEAVITT GROUP3 Filed as: LEAVITT INS. AGENCY OF SAN DIEGO | 3636 NOBEL DRIVE, SUITE 100 SAN DIEGO, CA 92122 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS. SVCS. | 9855 SCRANTON RD, SUITE 100 SAN DIEGO, CA 92121 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $111 | $111 | 1.05% |
| LEAVITT GROUP3 Filed as: LEAVITT INS. AGENCY OF SAN DIEGO | 3636 NOBEL DRIVE, SUITE 100 SAN DIEGO, CA 92122 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $771 | — | $771 | 10.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS. SVCS. | 9855 SCRANTON RD, SUITE 100 SAN DIEGO, CA 92121 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $92 | $92 | 1.19% |
| LEAVITT GROUP3 Filed as: LEAVITT INS. AGENCY OF SAN DIEGO | 3636 NOBEL DRIVE, SUITE 100 SAN DIEGO, CA 92122 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $507 | — | $507 | 15.01% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS. SVCS. | 9855 SCRANTON RD, SUITE 100 SAN DIEGO, CA 92121 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $41 | $41 | 1.21% |
| LEAVITT GROUP3 Filed as: LEAVITT INS. AGENCY OF SAN DIEGO | 3636 NOBEL DRIVE, SUITE 100 SAN DIEGO, CA 92122 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $142 | — | $142 | 9.98% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CA INS. SVCS. | 9855 SCRANTON RD, SUITE 100 SAN DIEGO, CA 92121 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $17 | $17 | 1.19% |
| SAMAR BREIK ALBIN3 | 41572 VALOR DR MURRIETA, CA 92562 | THE PAUL REVERE LIFE INSURANCE COMPANY | $176 | $18 | $194 | 16.64% |
| LEAVITT GROUP3 Filed as: LEAVITT GROUP BENEFIT SERVICES INC | 7881 WEST CHARLESTON BLVD LAS VEGAS, NV 89117 | THE PAUL REVERE LIFE INSURANCE COMPANY | $94 | — | $94 | 8.06% |
| DEL DOWNEY3 | 41960 AVENIDA DE ANITA TEMECULA, CA 92592 | THE PAUL REVERE LIFE INSURANCE COMPANY | $48 | — | $48 | 4.12% |
| ANDREA MARIE TIERCE3 | 2204 PLEASANTWOOD LN ESCONDIDO, CA 92026 | THE PAUL REVERE LIFE INSURANCE COMPANY | $47 | — | $47 | 4.03% |
| CALIFORNIA INSURANCE ADVOCATES INC3 | 41960 AVENIDA DE ANITA TEMECULA, CA 92592 | THE PAUL REVERE LIFE INSURANCE COMPANY | $40 | — | $40 | 3.43% |
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 | 103 | 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) | 104 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 95 | $1.1M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 95 | $722K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 95 | $722K |
| Life insurance(3 contracts, 3 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 103 | $42K |
| Short-term disability(3 contracts, 3 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 103 | $38K |
| Long-term disability(3 contracts, 3 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 103 | $45K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC. | 62 | $344K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 103 | $1K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 103 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
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.