| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: LBW INSURANCE AND FINANCIAL | 28055 SMYTH DRIVE VALENCIA, CA 91355 | BLUE CROSS OF CALIFORNIA | $25K | $0 | $25K | 3.21% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | BLUE CROSS OF CALIFORNIA | $13K | $0 | $13K | 1.64% |
| ACRISURE LLC3 Filed as: LBW INSURANCE AND FINANCIAL | 28055 SMYTH DRIVE VALENCIA, IL 91355 | KAISER FOUNDATION HEALTH PLAN INC | $11K | $0 | $11K | 2.24% |
| USI INSURANCE SERVICES LLC3 | 150 NORTH MICHIGAN, SUITE 3900 CHICAGO, IL 60601 | KAISER FOUNDATION HEALTH PLAN INC | $10K | $0 | $10K | 2.09% |
| ACRISURE LLC3 Filed as: LBW INSURANCE AND FINANCIAL | 28055 SMYTH DRIVE VALENCIA, CA 91355 | PRINCIPAL LIFE INSURANCE COMPANY | $3K | $0 | $3K | 2.77% |
| USI INSURANCE SERVICES LLC3 | 3247 WEST MARCH LANE, SUITE 210 STOCKTON, CA 95219 | PRINCIPAL LIFE INSURANCE COMPANY | $2K | $0 | $2K | 1.35% |
| USI INSURANCE SERVICES LLC3 | 21250 HAWTHORNE BOULEVARD SUITE 600 TORRANCE, CA 90503 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $604 | $2K | 10.78% |
| ACRISURE LLC3 Filed as: LBW INSURANCE AND FINANCIAL | 28055 SMYTH DRIVE VALENCIA, CA 91355 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $0 | $1K | 6.57% |
| ACRISURE LLC3 Filed as: LBW INSURANCE AND FINANCIAL | 28055 SMYTH DRIVE VALENCIA, VA 91355 | VISION SERVICE PLAN | $775 | $0 | $775 | 4.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 66119 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $691 | $0 | $691 | 3.57% |
| ENROLLEASE3 Filed as: ENROLLEASE, INC. DBA EASECENTRAL | 1980 FESTIVAL PLAZA DRIVE SUITE 810 LAS VEGAS, NV 89135 | VISION SERVICE PLAN | $222 | $0 | $222 | 1.15% |
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 | 224 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 14 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 238 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 141 | $1.3M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 223 | $117K |
| Vision(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 145 | $796K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 232 | $21K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 141 | $1.3M |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 232 | $21K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 232 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.