| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INTEGRATED INSURANCE SERVICES, INC.3 | PO BOX 609 SANTA BARBARA, CA 93102 | BLUE CROSS OF CALIFORNIA | $226K | — | $226K | 4.50% |
| INTEGRATED INSURANCE SERVICES, INC.3 | 801 GARDEN STREET, SUITE 300 SANTA BARBARA, CA 93101 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $34K | — | $34K | 8.33% |
| ALLIANT INSURANCE SERVICES, INC.3 | 701 B STREET, 6TH FLOOR SAN DIEGO, CA 92101 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $7K | — | $7K | 1.67% |
| ELIZABETH J DOWNEY3 Filed as: ELIZABETH J. DOWNEY | 2883 OAKWOOD DRIVE PORT HURON, MI 48060 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 3.62% |
| JOHN D EVANGELISTA3 Filed as: JOHN EVANGELISTA AND OTHER AGENTS | 26111 ANTONIO PARKWAY RANCHO SANTA MARGARITA, CA 92688 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $354 | — | $354 | 1.07% |
| JOHN M FICKEWIRTH AND ASSOCIATION I3 Filed as: JOHN M. FICKEWIRTH AND ASSOCIATES | PO BOX 3617 VENTURA, CA 93006 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $281 | — | $281 | 0.85% |
| WILLIAM L WISER3 Filed as: WILLIAM L. WISER | 12725 JARDIN ROAD SAN DIEGO, CA 92128 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $166 | — | $166 | 0.50% |
| INTEGRATED INSURANCE SERVICES, INC.3 | PO BOX 609 SANTA BARBARA, CA 93102 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $90 | — | $90 | 0.27% |
| MCCAREY INC3 Filed as: MCCAREY, INC. | 965 MESA DRIVE CAMARILLO, CA 93010 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $87 | — | $87 | 0.26% |
| MIKE MCCORMICK3 | 348 SOUTH STRONGS COURT SALT LAKE CITY, UT 84102 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $44 | — | $44 | 0.13% |
| INTEGRATED INSURANCE SERVICES, INC.3 | 90 CASTILLIAN DRIVE, SUITE 110 GOLETA, CA 93117 | FEDERAL INSURANCE COMPANY | $1K | — | $1K | 15.00% |
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 | 358 | 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) | 358 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 977 | $5.0M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 303 | $409K |
| Vision | BLUE CROSS OF CALIFORNIA | 977 | $5.0M |
| Life insurance(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 977 | $5.1M |
| Short-term disability(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 977 | $5.1M |
| Long-term disability | BLUE CROSS OF CALIFORNIA | 977 | $5.0M |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 977 | $5.0M |
| Other(3 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 977 | $5.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 977 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.