| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 Filed as: JOHNSON & DUGAN INSURANCE SERVICES | 1350 BAYSHORE HIGHWAY, SUITE 328 BURLINGAME, CA 94010 | CALIFORNIA PHYSICIANS'SERVICES/BLUE SHIELD OF CA | $0 | $61K | $61K | 3.10% |
| ASSUREDPARTNERS3 Filed as: JOHNSON & DUGAN INSURANCE SERVICES | 1350 BAYSHORE HIGHWAY, SUITE 328 BURLINGAME, CA 94010 | KAISER PERMANENTE | $31K | $0 | $31K | 4.58% |
| ASSUREDPARTNERS3 Filed as: JOHNSON & DUGAN INSURANCE SERVICES | 1350 BAYSHORE HIGHWAY, SUITE 328 BURLINGAME, CA 94010 | THE LINCOLN NATIONAL LIFE INSURANCE CO | $10K | $0 | $10K | 8.16% |
| ASSUREDPARTNERS3 Filed as: JOHNSON & DUGAN INS SERVICES | 1350 BAYSHORE HIGHWAY, SUITE 328 BURLINGAME, CA 94010 | VISION SERVICE PLAN | $2K | $0 | $2K | 3.25% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| THE GUARDIAN LIFE INSURANCE COMPANY EIN 13-5123390 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $32K |
| JOHNSON & DUGAN INSURANCE SERVICES EIN 94-2917627 INSURANCE BROKER | Insurance agents and brokers Service code 22 | — | $0 |
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 | 249 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 254 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS'SERVICES/BLUE SHIELD OF CA | 170 | $2.6M |
| Vision | VISION SERVICE PLAN | 244 | $64K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE CO | 249 | $128K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE CO | 249 | $128K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE CO | 249 | $128K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS'SERVICES/BLUE SHIELD OF CA | 170 | $2.6M |
| Other | CONCERN | 249 | $7K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 249 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.