| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | P.O. BOX 1788 GRAND RAPIDS, MI 49501 | UNITED HEALTHCARE INSURANCE COMPANY | $29K | — | $29K | 4.30% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 2655 CAMINO DEL RIO SAN DIEGO, CA 92108 | KAISER FOUNDATION HEALTH PLAN INC. | $24K | — | $24K | 4.05% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA | 3 POLARIS WAY ALISO VIEJO, CA 92656 | METROPOLITAN LIFE INSURANCE COMPANY | $13K | — | $13K | 10.52% |
| PROFESSIONAL GROUP PLANS INC3 Filed as: PROFESSIONAL GROUP PLANS | 225 WIRELESS BLVD. HAUPPAUGE, NY 11788 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | $2K | $8K | 6.75% |
| COLONIAL LIFE & ACCIDENT3 | P.O. BOX 1365 COLUMBIA, SC 29202 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9K | $760 | $9K | 25.24% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3 POLARIS WAY ALISO VIEJO, CA 92656 | SAFEGUARD HEALTH PLANS, INC. | $878 | — | $878 | 9.53% |
| PROFESSIONAL GROUP PLANS INC3 Filed as: PROFESSIONAL GROUP PLANS | 225 WIRELESS BLVD. HAUPPAUGE, NY 11788 | SAFEGUARD HEALTH PLANS, INC. | $439 | $402 | $841 | 9.13% |
| ENROLLEASE3 | 500 TREAT AVENUE SAN FRANCISCO, CA 94110 | SAFEGUARD HEALTH PLANS, INC. | $176 | — | $176 | 1.91% |
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 | 157 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 160 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 99 | $1.3M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 314 | $134K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 314 | $124K |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 314 | $161K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 28 | $37K |
| Prescription drug(2 contracts, 2 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 99 | $1.3M |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 314 | $161K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 314 | — |
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.