| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 Filed as: JOHNSON & DUGAN INSURANCE SERVICES | 390 BRIDGE PARKWAY, SUITE 200 REDWOOD CITY, CA 96065 | KAISER FOUNDATION HEALTH PLAN, INC. | $9K | $0 | $9K | 2.14% |
| ASSUREDPARTNERS3 Filed as: JOHNSON & DUGAN INSURANCE SERVICES | 390 BRIDGE PARKWAY, SUITE 200 REDWOOD CITY, CA 94065 | KAISER FOUNDATION HEALTH PLAN, INC. | $9K | $0 | $9K | 3.03% |
| ASSUREDPARTNERS3 Filed as: JOHNSON & DUGAN INSURANCE SERVICES | 390 BRIDGE PARKWAY, SUITE 200 REDWOOD CITY, CA 94065 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $8K | — | $8K | 10.00% |
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 | 96 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 96 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | KAISER FOUNDATION HEALTH PLAN, INC. | 43 | $735K |
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 96 | $79K |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 96 | $79K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 96 | $79K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 96 | $79K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 96 | $79K |
| Prescription drug(2 contracts) | KAISER FOUNDATION HEALTH PLAN, INC. | 43 | $735K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 96 | — |
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."
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.