| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DOUGLAS-MCCARTY INSURANCE SERVICES3 | PO BOX 5406 SAN CLEMENTE, CA 92674 | UNITED HEALTHCARE INSURANCE COMPANY | $75K | — | $75K | 5.96% |
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE SVS LLC | 1600 W HILLSDALE BLVD STE 201 SAN MATEO, CA 90636 | UNITED HEALTHCARE INSURANCE COMPANY | $12K | — | $12K | 0.99% |
| DOUGLAS-MCCARTY INSURANCE SERVICES3 | PO BOX 5406 SAN CLEMENTE, CA 92674 | KAISER PERMANENTE | $9K | $1K | $11K | 6.17% |
| AMWINS3 Filed as: LISI INC | 1600 W HILLSDALE BLVD STE 201 SAN MATEO, CA 94402 | KAISER PERMANENTE | $3K | — | $3K | 1.70% |
| DOUGLAS-MCCARTY INSURANCE SERVICES3 | PO BOX 5406 SAN CLEMENTE, CA 92674 | PRINCIPAL LIFE INSURANCE COMPANY | $15K | — | $15K | 9.99% |
| AMWINS3 Filed as: AMWINS CONNECT INS SERVICES | 1600 W HILLSDALE BLVD STE 201 SAN MATEO, CA 94402 | PRINCIPAL LIFE INSURANCE COMPANY | $4K | — | $4K | 3.00% |
| DOUGLAS T SMITH3 | 931 CALLE NEGOCIO SUITE J SAN CLEMENTE, CA 92673 | KAISER PERMANENTE | $3K | — | $3K | 3.60% |
| DOUGLAS-MCCARTY INSURANCE SERVICES3 | PO BOX 5406 SAN CLEMENTE, CA 92674 | STANDARD INSURANCE COMPANY | $8K | — | $8K | 15.70% |
| DOUGLAS-MCCARTY INSURANCE SERVICES3 | PO BOX 5406 SAN CLEMENTE, CA 92674 | STANDARD INSURANCE COMPANY | $6K | — | $6K | 15.72% |
| DOUGLAS-MCCARTY INSURANCE SERVICES3 | PO BOX 5406 SAN CLEMENTE, CA 92674 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 11.80% |
| DOUGLAS-MCCARTY INSURANCE SERVICES3 | PO BOX 5406 SAN CLEMENTE, CA 92674 | KAISER PERMANENTE | $260 | $31 | $291 | 6.71% |
| AMWINS3 Filed as: LISI INC | 1600 W HILLSDALE BLVD STE 201 SAN MATEO, CA 94402 | KAISER PERMANENTE | $77 | — | $77 | 1.78% |
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 | 194 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 196 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 2 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 288 | $1.5M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 170 | $145K |
| Vision | STANDARD INSURANCE COMPANY | 157 | $20K |
| Life insurance | STANDARD INSURANCE COMPANY | 193 | $49K |
| Long-term disability | STANDARD INSURANCE COMPANY | 195 | $39K |
| Prescription drug | UNITED HEALTHCARE INSURANCE COMPANY | 288 | $1.3M |
| Other | STANDARD INSURANCE COMPANY | 193 | $49K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 288 | — |
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.