| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 2010 MAIN STREET, SUITE 700 IRVINE, CA 92614 | HEALTH NET | $24K | — | $24K | 6.97% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 2010 MAIN STREET, SUITE 700 IRVINE, CA 92614 | KAISER FOUNDATION HEALTH PLAN, INC. | $15K | — | $15K | 4.62% |
| AMWINS3 Filed as: AMWINS CONNECT INS SVCS, LLC | 2677 N MAIN STREET. SUITE 800 SANTA ANA, CA 92705 | KAISER FOUNDATION HEALTH PLAN, INC. | $6K | — | $6K | 1.92% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 2010 MAIN STREET, SUITE 700 IRVINE, CA 92614 | PRINCIPAL LIFE INSURANCE COMPANY | $10K | — | $10K | 15.08% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS, LLC | 1787 SENTRY PKWY W BLDG 16 STE 320 BLUE BELL, PA 194222239 | PRINCIPAL LIFE INSURANCE COMPANY | — | $4K | $4K | 5.80% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INS SVCS INC | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 91361 | PRINCIPAL LIFE INSURANCE COMPANY | — | $122 | $122 | 0.19% |
| COLONIAL LIFE & ACCIDENT3 Filed as: COLONIAL - SEE ATTACHMENT | PO BOX 1365 COLUMBIA, SC 29202 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $172 | $3K | 24.72% |
| VARIOUS - SEE ATTACHED3 Filed as: AFLAC - SEE ATTACHMENT | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $298 | — | $298 | 10.66% |
| EVAN PENNET4 | 13725 CUMPSTON STREET SHERMAN OAKS, CA 91401 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $187 | — | $187 | 8.67% |
| MICHELLE A BABITZ4 | 28505 TAOS COURT CATHEDRAL CITY, CA 92234 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $23 | — | $23 | 1.07% |
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 | 148 | 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) | 148 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HEALTH NET | 43 | $662K |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 205 | $66K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 205 | $66K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 205 | $66K |
| Short-term disability(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 8 | $16K |
| Prescription drug(2 contracts, 2 carriers) | HEALTH NET | 43 | $662K |
| Other(4 contracts, 4 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 205 | $84K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 205 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.