| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | UNKNOWN DULLES, VA 20166 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $163K | $3K | $167K | 15.98% |
| RYAN BEDROSIAN3 | UNKNOWN DULLES, VA 20166 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $260 | $0 | $260 | 0.02% |
| ACRISURE LLC3 | PO BOX 7746 CITRUS HEIGHTS, CA 95621 | METROPOLITAN LIFE INSURANCE COMPANY | $72K | $0 | $72K | 13.39% |
| USI INSURANCE SERVICES LLC3 | 3190 FAIRVIEW PARK DRIVE FALLS CHURCH, VA 22042 | AETNA LIFE INSURANCE COMPANY | $6K | $0 | $6K | 11.43% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3 POLARIS WAY, 4TH FLOOR ALISO VIEJO, CA 92656 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $6K | $3K | $10K | 22.95% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | PO BOX 7746 CITRUS HEIGHTS, CA 95621 | METROPOLITAN GENERAL INSURANCE COMPANY | $2K | $0 | $2K | 9.83% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 100 OTTAWA AVENUE SW GRAND RAPIDS, MI 49503 | DELAWARE AMERICAN LIFE INSURANCE COMPANY | $873 | $0 | $873 | 15.00% |
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 | 281 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 281 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 372 | $1.1M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 661 | $590K |
| Vision(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 255 | $94K |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 661 | $543K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 661 | $537K |
| Long-term disability(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 661 | $543K |
| Prescription drug(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 372 | $1.1M |
| Other(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 661 | $560K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 661 | — |
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.