| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DOUGLAS-MCCARTY INSURANCE SERVICES3 | P.O. BOX 5406 SAN CLEMENTE, CA 92674 | AETNA HEALTH, INC. | $35K | $5K | $40K | 5.29% |
| DOUGLAS-MCCARTY INSURANCE SERVICES3 | P.O. BOX 5406 SAN CLEMENTE, CA 92674 | AETNA LIFE INSURANCE COMPANY | $3K | — | $3K | 4.58% |
| DOUGLAS-MCCARTY INSURANCE SERVICES3 | P.O. BOX 5406 SAN CLEMENTE, CA 92674 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $9K | $870 | $10K | 19.27% |
| AMWINS3 Filed as: LISI INC | 1600 WEST HILLSDALE BLVD SAN MATEO, CA 94402 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | — | $2K | $2K | 4.66% |
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 | 209 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 209 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA HEALTH, INC. | 163 | $836K |
| Dental | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 209 | $51K |
| Life insurance(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 209 | $124K |
| Prescription drug(2 contracts, 2 carriers) | AETNA HEALTH, INC. | 163 | $836K |
| Other | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 209 | $51K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 209 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
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.