| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ABD INS. AND FINANCIAL SVCS., INC.3 Filed as: ABD INSURANCE & FINANCIAL SVC INC | 5448 THORNWOOD DRIVE SAN JOSE, CA 95123 | CALIFORNIA PHYSICIANS SERVICE | $98K | $5K | $102K | 2.25% |
| ABD INS. AND FINANCIAL SVCS., INC.3 Filed as: ABD INSURANCE & FINANCIAL SVC INC | 3 WATERS PARK DRIVE, SUITE 100 SAN MATEO, CA 94403 | KAISER FOUNDATION HEALTH PLAN INC. | $32K | — | $32K | 4.00% |
| ABD INS. AND FINANCIAL SVCS., INC.3 Filed as: ABD INSURANCE & FINANCIAL SVC INC | 3 WATERS PARK DRIVE, SUITE 100 SAN MATEO, CA 94403 | METROPOLITAN LIFE INSURANCE COMPANY | $9K | $14K | $23K | 4.14% |
| ABD INS. AND FINANCIAL SVCS., INC.3 Filed as: ABD INSURANCE & FINANCIAL SVC INC | 3 WATERS PARK DRIVE, SUITE 100 SAN MATEO, CA 94403 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $12K | — | $12K | 2.69% |
| ABD INS. AND FINANCIAL SVCS., INC.3 Filed as: ABD INSURANCE & FINANCIAL SVC INC | 3 WATERS PARK DRIVE, SUITE 100 SAN MATEO, CA 94403 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $16K | — | $16K | 6.21% |
| PLANSOURCE BENEFITS ADMINISTRATION3 Filed as: PLANSOURCE BENEFIT ADMINISTRATORS | PO BOX 1313 ORLANDO, FL 32802 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 2.00% |
| ABD INS. AND FINANCIAL SVCS., INC.3 Filed as: ABD INSURANCE & FINANCIAL SVC INC | 3 WATER PARK DRIVE, SUITE 100 SAN MATEO, CA 94403 | VISION SERVICE PLAN | $3K | — | $3K | 2.45% |
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 | 810 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 10 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 820 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | CALIFORNIA PHYSICIANS SERVICE | 574 | $5.8M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 1,380 | $557K |
| Vision | VISION SERVICE PLAN | 717 | $114K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 810 | $263K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 810 | $263K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 810 | $263K |
| Prescription drug(3 contracts, 3 carriers) | CALIFORNIA PHYSICIANS SERVICE | 574 | $5.8M |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 810 | $263K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,380 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.