| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | AETNA LIFE INSURANCE COMPANY | $60K | — | $60K | 2.15% |
| HEFFERNAN INSURANCE BROKERS3 | 1350 CARLBACK AVE., SUITE 200 WALNUT CREEK, CA 94596 | AETNA LIFE INSURANCE COMPANY | $41K | — | $41K | 1.44% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | AETNA HEALTH, INC. | $21K | — | $21K | 2.61% |
| HEFFERNAN INSURANCE BROKERS3 | 1350 CARLBACK AVE., SUITE 200 WALNUT CREEK, CA 94596 | AETNA HEALTH, INC. | $11K | — | $11K | 1.39% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 5664 PRAIRIE CREEK DRIVE, SE CALEDONIA, MA 49316 | KAISER FOUNDATION HEALTH PLAN OF GEORGIA, INC. | $12K | — | $12K | 3.92% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 9035 SOQUEL AVE, STE 200 SANTA CRUZ, CA 95062 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $12K | $2K | $15K | 7.31% |
| HEFFERNAN INSURANCE BROKERS3 | 1350 CARLBACK AVE., SUITE 200 WALNUT CREEK, CA 94596 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 2.45% |
| LONG TERM CARE SOLUTIONS, INC.3 Filed as: LONG TERM CARE SOLUTIONS INC | 14715 NE 95TH ST, STE 200 REDMOND, WA 98052 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | — | $6K | 11.25% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 9035 SOQUEL AVE, STE 200 SANTA CRUZ, CA 95062 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 2.17% |
| HEFFERNAN INSURANCE BROKERS3 | 1350 CARLBACK AVE., SUITE 200 WALNUT CREEK, CA 94596 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $819 | — | $819 | 1.58% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 9035 SOQUEL AVE, STE 200 SANTA CRUZ, CA 95062 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $530 | $3K | 7.16% |
| HEFFERNAN INSURANCE BROKERS3 | 1350 CARLBACK AVE., SUITE 200 WALNUT CREEK, CA 94596 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 2.55% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 9035 SOQUEL AVE, STE 200 SANTA CRUZ, CA 95062 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $452 | $3K | 7.15% |
| HEFFERNAN INSURANCE BROKERS3 | 1350 CARLBACK AVE., SUITE 200 WALNUT CREEK, CA 94596 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $957 | — | $957 | 2.53% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 9035 SOQUEL AVE, STE 200 SANTA CRUZ, CA 95062 | VISION SERVICE PLAN | $1K | — | $1K | 3.14% |
| HEFFERNAN INSURANCE BROKERS3 | 1350 CARLBACK AVE., SUITE 200 WALNUT CREEK, CA 94596 | VISION SERVICE PLAN | $895 | — | $895 | 2.65% |
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 | 283 | 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) | 285 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | AETNA LIFE INSURANCE COMPANY | 583 | $5.4M |
| Dental | AETNA LIFE INSURANCE COMPANY | 583 | $2.8M |
| Vision | VISION SERVICE PLAN | 263 | $34K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 298 | $243K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 71 | $38K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 298 | $199K |
| Prescription drug(4 contracts, 4 carriers) | AETNA LIFE INSURANCE COMPANY | 583 | $5.4M |
| Other(3 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 308 | $295K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 583 | — |
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.