| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARK CARPENTER3 | 1100 INDUSTRIAL RD STE 3 SAN CARLOS, CA 940704131 | KAISER FOUNDATION HEALTH PLAN INC | $30K | $20 | $30K | 3.11% |
| MARK CARPENTER3 Filed as: MARK J CARPENTER | 1100 INDUSTRIAL RD STE 3 SAN CARLOS, CA 940704131 | UNITEDHEALTHCARE INSURANCE COMPANY | $8K | — | $8K | 6.61% |
| AMWINS3 Filed as: LISI LLC | 1600 W HILLSDALE BLVD STE 201 SAN MATEO, CA 944023766 | UNITEDHEALTHCARE INSURANCE COMPANY | $2K | — | $2K | 1.82% |
| CARPENTER, MARK J3 | 1100 INDUSTRIAL ROAD SUITE 3 SAN CARLOS, CA 94070 | UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. | $9K | — | $9K | 11.78% |
| MARK CARPENTER3 | 1100 INDUSTRIAL RD, #3 SAN CARLOS, CA 94070 | VSP | $2K | — | $2K | 10.00% |
| CARPENTER, MARK J3 | 1100 INDUSTRIAL ROAD SUITE 3 SAN CARLOS, CA 94070 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $766 | — | $766 | 14.81% |
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 | 113 | 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) | 113 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 159 | $1.1M |
| Dental | UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. | 133 | $78K |
| Vision | VSP | 106 | $18K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 133 | $5K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 133 | $5K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 159 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.