| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE SOUTHWEST PARTNERS INSURAN | 4000 WESTERLY PLACE SUITE 110 NEWPORT BEACH, CA 92660 | BLUE CROSS OF CALIFORNIA | $297K | — | $297K | 2.91% |
| ACRISURE LLC3 | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | BLUE CROSS OF CALIFORNIA | — | $11K | $11K | 0.11% |
| ACRISURE LLC3 Filed as: ACRISURE SOUTHWEST PARTNERS INSURAN | 611 ANTON BLVD STE 1400 COSTA MESA, CA 92626 | KAISER FOUNDATION HEALTH PLAN INC | $41K | — | $41K | 2.48% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3130 S HARBOR BLVD STE 140 SANTA ANA, CA 92704 | KAISER FOUNDATION HEALTH PLAN INC | $4K | — | $4K | 0.22% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3130 S HARBOR BLVD STE 140 SANTA ANA, CA 92704 | DELTA DENTAL OF CALIFORNIA | $100K | — | $100K | 10.00% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 611 ANTON BLVD, STE 1400 COSTA MESA, CA 92626 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | — | $2K | 4.54% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | L.B.L. INSURANCE SERVICES, LLC 100 OTTAWA AVENUE SW GRAND RAPIDS, MI 49503 | METROPOLITAN GENERAL INSURANCE COMPANY | $6K | — | $6K | 13.92% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3 POLARIS WAY 4TH FLOOR ALISO VIEJO, CA 92656 | KAISER FOUNDATION HEALTH PLAN OF COLORADO | $584 | — | $584 | 2.84% |
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 | 652 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 655 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 1,214 | $11.9M |
| Dental | DELTA DENTAL OF CALIFORNIA | 1,483 | $996K |
| Vision | VISION SERVICE PLAN | 520 | $90K |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 583 | $93K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,483 | — |
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.