| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | ATTN ACCOUNTING-WEST 1 PO BOX 1788 GRAND RAPIDS, MI 49501 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $33K | — | $33K | 9.69% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 10531 4S COMMONS DR, STE 166-516 SAN DIEGO, CA 92127 | KAISER FOUNDATION HEALTH PLAN INC | $14K | — | $14K | 5.28% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | DBA ELT INSURANCE SERVICES LLC PO BOX 1788 GRAND RAPIDS, MI 49501 | METROPOLITAN LIFE INSURANCE COMPANY | $7K | — | $7K | 9.17% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 9655 GRANITE RIDGE DR STE 500 SAN DIEGO, CA 92123 | METROPOLITAN LIFE INSURANCE COMPANY | — | $484 | $484 | 0.64% |
| GBAC PRIVATE HIX LLC3 | DBA EBENEFIT MARKETPLACE LLC 204 STATE ST NORTH HAVEN, CT 06473 | METROPOLITAN LIFE INSURANCE COMPANY | $180 | — | $180 | 0.24% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 16835 W BERNARDO DR STE 212 SAN DIEGO, CA 92127 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | — | $4K | 9.11% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 16835 W BERNARDO DR STE 212 SAN DIEGO, CA 92127 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 13.47% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | DBA ELT INSURANCE SERVICES LLC PO BOX 1788 GRAND RAPIDS, MI 49501 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | — | $4K | 17.80% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 9655 GRANITE RIDGE DR STE 500 SAN DIEGO, CA 92123 | METROPOLITAN LIFE INSURANCE COMPANY | — | $117 | $117 | 0.55% |
| GBAC PRIVATE HIX LLC3 Filed as: GBAC PROVIATE HIX LLC | DBA EBENEFIT MARKETPLACE LLC 204 STATE ST NORTH HAVEN, CT 06473 | METROPOLITAN LIFE INSURANCE COMPANY | $48 | — | $48 | 0.23% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 16835 W BERNARDO DR STE 212 SAN DIEGO, CA 92127 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 13.58% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | DBA ELT INSURANCE SERVICES LLC PO BOX 1788 GRAND RAPIDS, MI 49501 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | — | $3K | 17.94% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 9655 GRANITE RIDGE DR STE 500 SAN DIEGO, CA 92123 | METROPOLITAN LIFE INSURANCE COMPANY | — | $92 | $92 | 0.62% |
| GBAC PRIVATE HIX LLC3 | DBA EBENEFIT MARKETPLACE LLC 204 STATE ST NORTH HAVEN, CT 06473 | METROPOLITAN LIFE INSURANCE COMPANY | $32 | — | $32 | 0.21% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA | DBA ELT INSURANCE SERVICES LLC PO BOX 1788 GRAND RAPIDS, MI 49501 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | — | $2K | 17.90% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 9655 GRANITE RIDGE DR STE 500 SAN DIEGO, CA 92123 | METROPOLITAN LIFE INSURANCE COMPANY | — | $68 | $68 | 0.58% |
| GBAC PRIVATE HIX LLC3 | DBA EBENEFIT MARKETPLACE LLC 204 STATE ST NORTH HAVEN, CT 06473 | METROPOLITAN LIFE INSURANCE COMPANY | $28 | — | $28 | 0.24% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 16835 W BERNARDO DR STE 212 SAN DIEGO, CA 92127 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $714 | — | $714 | 9.10% |
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 | 331 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 331 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 59 | $270K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 314 | $337K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 754 | $76K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 331 | $43K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 19 | $25K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 91 | $19K |
| Other(4 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 331 | $56K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 754 | — |
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.