| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 Filed as: JOHNSON & DUGAN INSURANCE SERVICES | 390 BRIDGE PARKWAY, STE 200 REDWOOD CITY, CA 94065 | CALIFORNIA PHYSICIANS' SERVICE (BLUE SHIELD OF CALIFORNIA) | $249K | $249 | $249K | 2.57% |
| ASSUREDPARTNERS3 Filed as: JOHNSON & DUGAN INSURANCE SERVICES | 390 BRIDGE PARKWAY, SUITE 200 REDWOOD CITY, CA 94065 | KAISER FOUNDATION HEALTH PLAN, INC. | $46K | $0 | $46K | 3.17% |
| ASSUREDPARTNERS3 Filed as: JOHNSON & DUGAN INSURANCE SERVICES | 390 BRIDGE PARKWAY, SUITE 200 REDWOOD CITY, CA 94065 | METROPOLITAN LIFE INSURANCE COMPANY | $54K | $0 | $54K | 4.82% |
| PLANSOURCE BENEFITS ADMINISTRATION3 | 101 S GARLAND AVE STE 203 ORLANDO, FL 328013277 | METROPOLITAN LIFE INSURANCE COMPANY | $8K | $0 | $8K | 0.75% |
| WATCHTOWER TECHNOLOGIES INC3 Filed as: WATCHTOWER BENEFITS LLC/THREEFLOW | 306 W ERIE ST STE 300 CHICAGO, IL 606543902 | METROPOLITAN LIFE INSURANCE COMPANY | -$4K | $0 | -$4K | -0.34% |
| ASSUREDPARTNERS3 Filed as: JOHNSON & DUGAN INSURANCE SERVICES | 390 BRIDGE PARKWAY, SUITE 200 REDWOOD CITY, CA 94065 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $59K | $0 | $59K | 10.00% |
| WATCHTOWER TECHNOLOGIES INC3 Filed as: WATCHTOWER TECH. INC/THREEFLO | 306 WEST ERIE STREET, FLOOR 3 CHICAGO, IL 60654 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $4K | $4K | 0.65% |
| ASSUREDPARTNERS3 Filed as: JOHNSON & DUGAN INSURANCE SERVICES | 390 BRIDGE PARKWAY, SUITE 200 REDWOOD CITY, CA 94065 | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC. | $6K | $0 | $6K | 3.00% |
| ASSUREDPARTNERS3 Filed as: JOHNSON & DUGAN INSURANCE SERVICES | 390 BRIDGE PARKWAY, STE 200 REDWOOD CITY, CA 94065 | EYEMED VISION CARE | $15K | $0 | $15K | 10.58% |
| THREEFLOW3 | 306 W. ERIE STREET, SUITE 300 CHICAGO, IL 60654 | EYEMED VISION CARE | $523 | $0 | $523 | 0.36% |
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 | 848 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 13 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 861 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | CALIFORNIA PHYSICIANS' SERVICE (BLUE SHIELD OF CALIFORNIA) | 818 | $11.4M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 1,639 | $1.1M |
| Vision | EYEMED VISION CARE | 734 | $146K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 848 | $585K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 848 | $585K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 848 | $585K |
| Prescription drug(3 contracts, 3 carriers) | CALIFORNIA PHYSICIANS' SERVICE (BLUE SHIELD OF CALIFORNIA) | 532 | $11.4M |
| Other(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 848 | $605K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,639 | — |
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."
No prospect flags tripped on this filing.