| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INTEGRATED INSURANCE SERVICES, INC.3 Filed as: INTEGRATED INSURANCE SERVICES INC | PO BOX 609 SANTA BARBARA, CA 93102 | BLUE CROSS OF CALIFORNIA | $311K | $1K | $312K | 5.60% |
| INTEGRATED INSURANCE SERVICES, INC.3 Filed as: INTEGRATED INSURANCE SERVICES | PO BOX 609 SANTA BARBARA, CA 93102 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $49K | — | $49K | 10.00% |
| ELIZABETH J DOWNEY3 Filed as: ELIZABETH J. DOWNEY | 6113 NORTH CUMBERLAND ROAD MUNCIE, IN 47304 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 4.01% |
| MJ INSURANCE3 Filed as: ANDREA M. TIERCE AND VARIOUS AGENTS | 2204 PLEASANTWOOD LANE ESCONDIDO, CA 92026 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $449 | — | $449 | 1.16% |
| JOHN M FICKEWIRTH AND ASOC3 Filed as: JOHN M. FICKEWRITH AND ASSOCIATES | PO BOX 3617 VENTURA, CA 93006 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $344 | — | $344 | 0.89% |
| WILLIAM L WISER3 Filed as: WILLIAM L. WISER | 12725 JARDIN ROAD SAN DIEGO, CA 92128 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $180 | — | $180 | 0.47% |
| MCCAREY INC3 | 965 MESA DRIVE CAMARILLO, CA 93010 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $129 | — | $129 | 0.33% |
| INTEGRATED INSURANCE SERVICES, INC.3 Filed as: INTEGRATED INSURANCE SERVICES INC | PO BOX 609 SANTA BARBARA, CA 93102 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $101 | — | $101 | 0.26% |
| DEBORAH ALEXAKOS3 | 5475 NORTH MITCHUM AVENUE MERIDIAN, ID 83646 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $59 | — | $59 | 0.15% |
| INTEGRATED INSURANCE SERVICES, INC.3 | 90 CASTILLIAN DRIVE, SUITE 110 GOLETA, CA 93117 | FEDERAL INSURANCE COMPANY | $1K | — | $1K | 15.00% |
| INTEGRATED INSURANCE SERVICES, INC.3 | 90 CASTILLIAN DRIVE, SUITE 110 GOLETA, CA 93117 | FEDERAL INSURANCE COMPANY | $827 | — | $827 | 15.01% |
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 | 303 | 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) | 303 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 820 | $5.6M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 303 | $487K |
| Vision | BLUE CROSS OF CALIFORNIA | 820 | $5.6M |
| Life insurance(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 820 | $5.6M |
| Short-term disability(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 820 | $5.6M |
| Long-term disability | BLUE CROSS OF CALIFORNIA | 820 | $5.6M |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 820 | $5.6M |
| Other(4 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 820 | $5.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 820 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.