| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 9655 GRANITE RIDGE DR STE 500 SAN DIEGO, CA 92123 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $130K | — | $130K | 22.30% |
| THE BENEFIT COMPANY INC3 Filed as: THE BENEFIT COMPANY | 6 CONCOURSE PKWY NE STE 2750 ATLANTA, GA 30328 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | -$320 | — | -$320 | -0.06% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 2055 WOODSIDE RD STE 290 REDWOOD CITY, CA 94061 | METROPOLITAN LIFE INSURANCE COMPANY | $44K | — | $44K | 14.92% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 9655 GRANITE RIDGE DR STE 500 SAN DIEGO, CA 92123 | METROPOLITAN LIFE INSURANCE COMPANY | — | $2K | $2K | 0.56% |
| THE BENEFIT COMPANY INC3 Filed as: THE BENEFIT COMPANY LLC | 6 CONCOURSE PKWY NE STE 2750 ATLANTA, GA 30328 | METROPOLITAN LIFE INSURANCE COMPANY | -$2K | $3K | $372 | 0.13% |
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 | 347 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 350 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 302 | $581K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 732 | $293K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 732 | $293K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 732 | $293K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 732 | $293K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 732 | $293K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 732 | $293K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 732 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.