| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 1120 BRISTOL ST. COSTA MESA, CA 92626 | CALIFORNIA PHYSICIANS' SERVICE | $56K | — | $56K | 5.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: DICKERSON EMPLOYEE BENEFITS | AN ALERA GROUP AGENCY, LLC 1918 RIVERSIDE DRIVE LOS ANGELES, CA 90039 | CALIFORNIA PHYSICIANS' SERVICE | — | $23K | $23K | 2.08% |
| SCHEIBNER, JEFFREY L3 Filed as: SCHEIBNER, JEFFREY LLOYD | 28562 OSO PKWY D526 RANCHO STA MARG, CA 92688 | CALIFORNIA PHYSICIANS' SERVICE | $1K | — | $1K | 0.13% |
| ACRISURE LLC3 Filed as: ACRISURE SOUTHWEST PARTNERS | INSURANCE SERVICES LLC 4000 WESTERLY PL STE 110 NEWPORT BEACH, CA 92660 | PRINCIPAL LIFE INSURANCE COMPANY | $7K | $2K | $9K | 10.45% |
| GA SOLUTIONS LLC3 | 311 CLOCK TOWER CMNS BREWSTER, NY 10509 | PRINCIPAL LIFE INSURANCE COMPANY | — | $4K | $4K | 4.29% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | DBA SHOREPOINT INS 1120 BRISTOL ST COSTA MESA, CA 92626 | PRINCIPAL LIFE INSURANCE COMPANY | $2K | — | $2K | 2.55% |
| ACRISURE LLC3 | PO BOX 1788 GRAND RAPIDS, MI 49501 | PRINCIPAL LIFE INSURANCE COMPANY | — | $597 | $597 | 0.66% |
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 | 103 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 103 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA PHYSICIANS' SERVICE | 168 | $1.1M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 184 | $90K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 184 | $90K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 184 | $90K |
| Prescription drug | CALIFORNIA PHYSICIANS' SERVICE | 168 | $1.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 184 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.