| 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 | $48K | — | $48K | 5.47% |
| LEAVITT GROUP3 Filed as: LEAVITT INS. AGENCY OF SAN DIEGO | 3636 NOBEL DRIVE, SUITE 100 SAN DIEGO, CA 92122 | KAISER FOUNDATION HEALTH PLAN INC. | $14K | — | $14K | 4.73% |
| DEL DOWNEY3 | 32056 MERLOT CRST TEMECULA, CA 92591 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $152 | $1K | 7.53% |
| LEAVITT GROUP3 Filed as: LEAVITT GROUP BENEFIT SERVICES INC | 7881 WEST CHARLESTON BLVD. LAS VEGAS, NV 89117 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 7.41% |
| STACI MARIE FERRARIS3 | 28912 GLEN ROCK PLACE HIGHLAND, CA 92346 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $393 | $43 | $436 | 2.77% |
| ANDREA MARIE TIERCE3 | 2204 PLEASANTWOOD LN ESCONDIDO, CA 92026 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $250 | $93 | $343 | 2.18% |
| ANTONIA DAVILA3 Filed as: ANTONIA MARIA HOLDEN | 8932 CREEKFORD ST LAKESIDE, CA 92040 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $213 | $8 | $221 | 1.40% |
| SAMAR BREIK ALBIN3 | 41572 VALOR DR. MURRIETA, CA 92562 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $104 | $31 | $135 | 0.86% |
| MARTHA ANGELICA HILL ESTRADA3 | 2991 ESCALA CIRCLE SAN DIEGO, CA 92108 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $77 | $20 | $97 | 0.62% |
| 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 | $957 | — | $957 | 10.00% |
| 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 | $628 | — | $628 | 9.99% |
| 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 | $452 | — | $452 | 15.02% |
| LEAVITT GROUP3 Filed as: LEAVITT GROUP BENEFIT SERVICES INC | 7881 WEST CHARLESTON BLVD LAS VEGAS, NV 89117 | THE PAUL REVERE LIFE INSURANCE COMPANY | $86 | — | $86 | 6.76% |
| SAMAR BREIK ALBIN3 | 41572 VALOR DR MURRIETA, CA 92562 | THE PAUL REVERE LIFE INSURANCE COMPANY | $34 | $2 | $36 | 2.83% |
| DEL DOWNEY3 | 32056 MERLOT CRST TEMECULA, CA 92591 | THE PAUL REVERE LIFE INSURANCE COMPANY | $17 | — | $17 | 1.34% |
| ANDREA MARIE TIERCE3 | 2204 PLEASANTWOOD LN ESCONDIDO, CA 92026 | THE PAUL REVERE LIFE INSURANCE COMPANY | $14 | — | $14 | 1.10% |
| 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 | $125 | — | $125 | 10.03% |
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 | 108 | 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) | 109 | 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 | 96 | $1.2M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 96 | $874K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 96 | $874K |
| Life insurance(3 contracts, 3 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 108 | $23K |
| Short-term disability(3 contracts, 3 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 108 | $20K |
| Long-term disability(3 contracts, 3 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 108 | $27K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC. | 62 | $300K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 108 | $1K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 108 | — |
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.