| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DOUGLAS-MCCARTY INSURANCE SERVICES3 | P.O. BOX 5406 SAN CLEMENTE, CA 92674 | BLUE SHIELD OF CALIFORNIA | $38K | — | $38K | 5.00% |
| AMWINS3 Filed as: LISI, INC. | 1600 W HILLSDALE BLVD SAN MATEO, CA 94402 | BLUE SHIELD OF CALIFORNIA | $15K | — | $15K | 2.00% |
| DOUGLAS-MCCARTY INSURANCE SERVICES3 | P.O BOX 5406 SAN CLEMENTE, CA 92674 | GUARDIAN | $4K | — | $4K | 6.89% |
| CHARLES BOGUE3 | 510 6TH STREET #815 LOS ANGELES, CA 90014 | GUARDIAN | $36 | — | $36 | 0.07% |
| DOUGLAS-MCCARTY INSURANCE SERVICES3 | P.O. BOX 5406 SAN CLEMENTE, CA 92674 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 10.00% |
| DOUGLAS-MCCARTY INSURANCE SERVICES3 | P.O. BOX 5406 SAN CLEMENTE, CA 92674 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $859 | — | $859 | 10.00% |
| DOUGLAS-MCCARTY INSURANCE SERVICES3 | P.O. BOX 5406 SAN CLEMENTE, CA 92674 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $638 | — | $638 | 10.00% |
| DOUGLAS-MCCARTY INSURANCE SERVICES3 | P.O. BOX 5406 SAN CLEMENTE, CA 92674 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $373 | — | $373 | 10.01% |
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 | 134 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 134 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE SHIELD OF CALIFORNIA | 99 | $768K |
| Dental | GUARDIAN | 96 | $53K |
| Vision | GUARDIAN | 96 | $53K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 134 | $19K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 16 | $6K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 21 | $4K |
| Prescription drug | BLUE SHIELD OF CALIFORNIA | 99 | $768K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 134 | $19K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 134 | — |
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.