| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DOUGLAS-MCCARTY INSURANCE SERVICES3 | PO BOX 5406 SAN CLEMENTE, CA 92674 | AETNA HEALTH, INC. | $42K | — | $42K | 5.03% |
| DOUGLAS-MCCARTY INSURANCE SERVICES3 | PO BOX 5406 SAN CLEMENTE, CA 92674 | AETNA LIFE INSURANCE CO. | $5K | — | $5K | 5.09% |
| DOUGLAS-MCCARTY INSURANCE SERVICES3 | PO BOX 5406 SAN CLEMENTE, CA 92674 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $6K | — | $6K | 9.74% |
| AMWINS3 Filed as: LISI LLC | 1600 W HILLSDALE BLVD SUITE 201 SAN MATEO, CA 94403 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | — | $616 | $616 | 1.03% |
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 | 198 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 198 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA HEALTH, INC. | 143 | $927K |
| Dental | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 204 | $60K |
| Life insurance | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 204 | $60K |
| Prescription drug(2 contracts, 2 carriers) | AETNA HEALTH, INC. | 143 | $927K |
| Other | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 204 | $60K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 204 | — |
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.