| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 Filed as: JOHNSON & DUGAN INSURANCE SERVICES | 1350 BAYSHORE HIGHWAY, STE 328 BURLINGAME, CA 94010 | CALIFORNIACHOICE | $48K | $0 | $48K | 4.99% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFIT GROUP | 6155 ALMEDEN EXPRESSWAY, STE 210 SAN JOSE, CA 95120 | CALIFORNIACHOICE | $29K | $0 | $29K | 2.99% |
| BENEFITMALL3 Filed as: BENEFITMALL HOLDING INC DBA DKG INS | 12404 PARK CENTRAL DR., STE 400S DALLAS, TX 752511800 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $403 | $4K | 3.64% |
| ASSUREDPARTNERS3 Filed as: JOHNSON & DUGAN INSURANCE SERVICES | 1350 BAYSHORE HIGHWAY, STE 328 BURLINGAME, CA 94010 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $0 | $3K | 3.27% |
| ASSUREDPARTNERS3 Filed as: JOHNSON & DUGAN INSURANCE SERVICES | 1350 BAYSHORE HIGHWAY, STE 328 BURLINGAME, CA 94010 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | $1K | $8K | 13.86% |
| ASSUREDPARTNERS3 Filed as: JOHNSON & DUGAN INSURANCE SERVICES | 1350 BAYSHORE HIGHWAY, STE 328 BURLINGAME, CA 94010 | VISION SERVICE PLAN | $1K | $0 | $1K | 4.73% |
| ASSUREDPARTNERS3 Filed as: JOHNSON & DUGAN INSURANCE SERVICES | 1350 BAYSHORE HIGHWAY, STE 328 BURLINGAME, CA 94010 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $332 | $25 | $357 | 10.74% |
| ASSUREDPARTNERS3 Filed as: JOHNSON & DUGAN INSURANCE SERVICES | 1350 BAYSHORE HIGHWAY, STE 328 BURLINGAME, CA 94010 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $153 | $0 | $153 | 8.98% |
| BENEFITMALL3 Filed as: BENEFITMALL HOLDING INC DBA DKG INS | 12404 PARK CENTRAL DR, STE 400S DALLAS, TX 752511800 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $61 | $9 | $70 | 4.11% |
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 | 124 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 126 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIACHOICE | 110 | $967K |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 235 | $101K |
| Vision | VISION SERVICE PLAN | 104 | $30K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 124 | $64K |
| Short-term disability(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 124 | $64K |
| Long-term disability(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 124 | $64K |
| Prescription drug | CALIFORNIACHOICE | 110 | $967K |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 124 | $64K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 235 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.