| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFONRIA LLC | 901 E HAMILTON AVEUE SUITE 410 CAMPBELL, CA 95008 | CALIFORNIA CHOICE | $43K | — | $43K | 5.06% |
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE SVC LLC | 2677 N MAIN STREET SANTA ANA, CA 92705 | CALIFORNIA CHOICE | $23K | — | $23K | 2.67% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA | 910 EHAMILTON AVENUE SUITE 410 CAMPBELL, CA 95008 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | — | $6K | 4.70% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DRIVE URBANDALE, IA 50323 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | — | $6K | 4.62% |
| ENROLLEASE3 Filed as: ENROLLEASE INC | 7979 OLD GEORGETOWN ROAD SUITE 300 BETHESDA, MD 20814 | METROPOLITAN LIFE INSURANCE COMPANY | — | $2K | $2K | 1.49% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA | AHERN INSURANCE BROKERAGE 1615 MURRAY CANYON RD, SUITE 1050 SAN DIEGO, CA 92108 | METROPOLITAN LIFE INSURANCE COMPANY | — | $1K | $1K | 1.16% |
| LEAVITT GROUP3 Filed as: LEAVITT PACIFIC INS BROKERS INC | 695 CAMPBELL TECHNOLOGY PKWY SUITE 250 CAMPBELL, CA 95008 | METROPOLITAN LIFE INSURANCE COMPANY | $867 | — | $867 | 0.72% |
| MJ INSURANCE3 Filed as: VARIOUS BROKERS | PO BOX 1365 COLUMBIA, SC 29202 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $1K | $3K | 72.19% |
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 | 173 | 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) | 173 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA CHOICE | 129 | $846K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 269 | $120K |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 269 | $124K |
| Long-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 5 | $4K |
| Prescription drug | CALIFORNIA CHOICE | 129 | $846K |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 269 | $124K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 269 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.