| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DOUGLAS-MCCARTY INSURANCE SERVICES3 | P.O. BOX 5406 SAN CLEMENTE, CA 92674 | UNITED HEALTHCARE INSURANCE COMPANY | $31K | — | $31K | 4.62% |
| DOUGLAS-MCCARTY INSURANCE SERVICES3 | P.O. BOX 5406 SAN CLEMENTE, CA 92674 | GUARDIAN | $4K | — | $4K | 7.53% |
| CHARLES BOGUE3 | 2200 HOMET RD SAN MARINO, CA 91108 | GUARDIAN | $75 | — | $75 | 0.15% |
| DOUGLAS-MCCARTY INSURANCE SERVICES3 | P.O. BOX 5406 SAN CLEMENTE, CA 92674 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $932 | — | $932 | 10.00% |
| DOUGLAS-MCCARTY INSURANCE SERVICES3 | P.O. BOX 5406 SAN CLEMENTE, CA 92674 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $750 | — | $750 | 10.00% |
| DOUGLAS-MCCARTY INSURANCE SERVICES3 | P.O. BOX 5406 SAN CLEMENTE, CA 92674 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $465 | — | $465 | 10.00% |
| DOUGLAS-MCCARTY INSURANCE SERVICES3 | P.O. BOX 5406 SAN CLEMENTE, CA 92674 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $225 | — | $225 | 10.02% |
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 | 130 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 130 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITED HEALTHCARE INSURANCE COMPANY | 85 | $666K |
| Dental | GUARDIAN | 82 | $50K |
| Vision | GUARDIAN | 82 | $50K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 130 | $17K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 18 | $5K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 24 | $2K |
| Prescription drug | UNITED HEALTHCARE INSURANCE COMPANY | 85 | $666K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 130 | $17K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 130 | — |
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.