| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST INS | SERVICES 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | KAISER FOUNDATION HEALTH PLAN, INC. | $25K | — | $25K | 3.35% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 95008 | KAISER FOUNDATION HEALTH PLAN, INC. | $12K | — | $12K | 1.63% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST INS | SERVICES 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | KAISER FOUNDATION HEALTH PLAN, INC. | $24K | — | $24K | 3.33% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 95008 | KAISER FOUNDATION HEALTH PLAN, INC. | $12K | — | $12K | 1.66% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST INS | SERVICES LLC 3155 OLSEN DR SAN JOSE, CA 95117 | METROPOLITAN LIFE INSURANCE COMPANY | $14K | $3K | $17K | 5.34% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 3697 MT DIABLO BLVD STE 100 LAFAYETTE, CA 94549 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $998 | $5K | 1.43% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 2390 HUNTINGTON DR SAN MARINO, CA 91108 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $12K | — | $12K | 5.97% |
| DISABILITY SPECIALISTS INC3 | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $11K | — | $11K | 5.65% |
| IMG3 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $111 | $111 | 0.06% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 701 B STREET SUITE 600 SAN DIEGO, CA 92101 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $6K | — | $6K | 3.70% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST | INSURANCE SERVICES, LLC 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | VISION SERVICE PLAN | $1K | — | $1K | 3.04% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | PO BOX 103129 PASADENA, CA 91189 | VISION SERVICE PLAN | $363 | — | $363 | 0.76% |
| GCG FINANCIAL LLC3 Filed as: MORRIS & BOYLE, AN ALERA | INSURANCE AGENCY 1850 MT DIABLO BLVD, STE 430 WALNUT CREEK, CA 94596 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $1K | $6K | 24.45% |
| M FINANCIAL HOLDINGS INC3 | 1125 NW COUCH ST SUITE 900 PORTLAND, OR 97209 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $592 | $592 | 2.59% |
| BENEFIT ADVISORS NETWORK LLC3 Filed as: BENEFIT ADVISORS NETWORK | 3659 GREEN RD STE 322-8 BEACHWOOD, OH 44122 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $89 | $89 | 0.39% |
| GCG FINANCIAL LLC3 Filed as: MORRIS & BOYLE, AN ALERA | INSURANCE AGENCY 1850 MT DIABLO BLVD, STE 430 WALNUT CREEK, CA 94596 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $1K | $4K | 18.98% |
| M FINANCIAL HOLDINGS INC3 | 1125 NW COUCH ST STE 900 PORTLAND, OR 97209 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $376 | $376 | 2.01% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST | INSURANCE SERVICES LLC 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $897 | $130 | $1K | 51.15% |
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 | 477 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 477 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 85 | $1.7M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 691 | $317K |
| Vision | VISION SERVICE PLAN | 378 | $48K |
| Life insurance | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 543 | $194K |
| Short-term disability | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 543 | $194K |
| Long-term disability | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 543 | $194K |
| Prescription drug(3 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 85 | $1.7M |
| Other(4 contracts, 2 carriers) | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 543 | $237K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 691 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.