| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 16835 W BERNARDO DR STE 212 SAN DIEGO, CA 92127 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $104K | — | $104K | 13.06% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 16835 W BERNARDO DR STE 212 SAN DIEGO, CA 92127 | KAISER FOUNDATION HEALTH PLAN INC | $8K | — | $8K | 5.83% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | D/B/A ELT INSURANCE SERVICES LLC 16835 W BERNARDO DR STE 212 SAN DIEGO, CA 92127 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | — | $2K | 10.45% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | D/B/A ELT INSURANCE SERVICES LLC 16835 W BERNARDO DR STE 212 SAN DIEGO, CA 92127 | METROPOLITAN LIFE INSURANCE COMPANY | $159 | — | $159 | 19.75% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | D/B/A ELT INSURANCE SERVICES LLC 16835 W BERNARDO DR STE 212 SAN DIEGO, CA 92127 | METROPOLITAN LIFE INSURANCE COMPANY | $135 | — | $135 | 20.06% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | D/B/A ELT INSURANCE SERVICES LLC 16835 W BERNARDO DR STE 212 SAN DIEGO, CA 92127 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $37 | — | $37 | 26.24% |
| GBAC PRIVATE HIX LLC3 | D/B/A EBENEFIT MARKETPLACE LLC 37 BROADWAY FL 2 NORTH HAVEN, CT 06473 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | $12 | — | $12 | 8.51% |
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 | 195 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 201 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 186 | $942K |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 508 | $21K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 508 | $21K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 508 | $21K |
| Other(3 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 508 | $23K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 508 | — |
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.