| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DOUGLAS-MCCARTY INSURANCE SERVICES3 | PO BOX 5406 SAN CLEMENTE, CA 92674 | AETNA LIFE INSURANCE CO. | $27K | — | $27K | 5.93% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFIT GROUP | 5110 N 40TH STREET PHOENIX, AZ 85018 | AETNA LIFE INSURANCE CO. | $14K | — | $14K | 3.05% |
| DOUGLAS-MCCARTY INSURANCE SERVICES3 | PO BOX 5406 SAN CLEMENTE, CA 92674 | AETNA HEALTH, INC. | $11K | — | $11K | 5.94% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFIT GROUP | 5110 N 40TH STREET PHOENIX, AZ 85018 | AETNA HEALTH, INC. | $5K | — | $5K | 2.61% |
| DOUGLAS-MCCARTY INSURANCE SERVICES3 | PO BOX 5406 SAN CLEMENTE, CA 92674 | STANDARD INSURANCE COMPANY | $7K | — | $7K | 13.11% |
| DOUGLAS-MCCARTY INSURANCE SERVICES3 | PO BOX 5406 SAN CLEMENTE, CA 92674 | STANDARD INSURANCE COMPANY | $4K | $1K | $5K | 25.45% |
| DOUGLAS-MCCARTY INSURANCE SERVICES3 | PO BOX 5406 SAN CLEMENTE, CA 92674 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 16.32% |
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 | 99 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 99 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA LIFE INSURANCE CO. | 91 | $635K |
| Dental | STANDARD INSURANCE COMPANY | 82 | $55K |
| Vision | STANDARD INSURANCE COMPANY | 99 | $11K |
| Life insurance | STANDARD INSURANCE COMPANY | 123 | $21K |
| Prescription drug(2 contracts, 2 carriers) | AETNA LIFE INSURANCE CO. | 91 | $635K |
| Other | STANDARD INSURANCE COMPANY | 123 | $21K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 123 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.