| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 5664 PRAIRIE CREEK DR SE CALEDONIA, MI 49316 | KAISER FOUNDATION HEALTH PLAN INC | $52K | — | $52K | 3.47% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 9140 E HAMILTON AVE #410 CAMPBELL, CA 95008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $3K | $8K | 7.24% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 9140 E HAMILTON AVE #410 CAMPBELL, CA 95008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $3K | $6K | 7.48% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 9140 E HAMILTON AVE #410 CAMPBELL, CA 95008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $3K | $6K | 7.26% |
| SECURA CONSULTANTS LLC3 | 6564 WAYZATA BLVD, STE 920 STE 920 ST. LOUIS PARK, MN 55426 | STANDARD INSURANCE COMPANY | $5K | — | $5K | 16.06% |
| JOSEPH GIBSON3 | 220 MONTGOMERY ST STE 438 SAN FRANCISCO, CA 94104 | STANDARD INSURANCE COMPANY | $5K | — | $5K | 15.77% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 5776 STONERIDGE MALL RD STE 250 PLEASANTON, CA 94558 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 6.32% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 9140 E HAMILTON AVE #410 CAMPBELL, CA 95008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $855 | $2K | 7.24% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 5664 PRAIRIE CREEK DR SE CALEDONIA, MI 49316 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | — | $1K | $1K | — |
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 | 346 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 15 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 361 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 181 | $1.5M |
| Life insurance(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 390 | $165K |
| Short-term disability(3 contracts, 3 carriers) | STANDARD INSURANCE COMPANY | 390 | $60K |
| Long-term disability(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 390 | $108K |
| Other(4 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 390 | $183K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 390 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.