| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 39 MAIN ST TIBURON, CA 94920 | CALIFORNIA PHYSICIANS' SERVICE | — | $174K | $174K | 6.39% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | PO BOX 7746 CITRUS HEIGHTS, CA 95621 | KAISER FOUNDATION HEALTH PLAN INC | $41K | — | $41K | 5.94% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | PO BOX 1788 GRAND RAPIDS, MI 49501 | DELTA DENTAL OF CALIFORNIA | $18K | — | $18K | 12.19% |
| PROFESSIONAL GROUP PLANS INC3 | 225 WIRELESS BLVD HAUPPAUGE, NY 11788 | DELTA DENTAL OF CALIFORNIA | $8K | — | $8K | 5.00% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | PO BOX 1788 GRAND RAPIDS, MI 49501 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | — | $4K | 11.80% |
| PROFESSIONAL GROUP PLANS INC3 | 225 WIRELESS BLVD #308 HAUPPAUGE, NY 11788 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $2K | $2K | 5.83% |
| ARCHON LLC3 | 225 WIRELESS BLVD HAUPPAUGE, NY 11788 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $2K | $2K | 4.17% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | PO BOX 1788 GRAND RAPIDS, MI 49501 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | — | $3K | 11.80% |
| PROFESSIONAL GROUP PLANS INC3 | 225 WIRELESS BLVD #308 HAUPPAUGE, NY 11788 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $2K | $2K | 5.67% |
| ARCHON LLC3 | 225 WIRELESS BLVD HAUPPAUGE, NY 11788 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $1K | $1K | 4.19% |
| PROFESSIONAL GROUP PLANS INC3 Filed as: PROFESSIONAL GROUP PLANS. | 225 WIRELESS BLVD FL 2 HAUPPAUGE, NY 11788 | VISION SERVICE PLAN | $1K | — | $1K | 4.99% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC DBA | BEDROSIAN 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | VISION SERVICE PLAN | $1K | — | $1K | 4.79% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | PO BOX 1788 GRAND RAPIDS, MI 49501 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | — | $3K | 11.80% |
| PROFESSIONAL GROUP PLANS INC3 | 225 WIRELESS BLVD #308 HAUPPAUGE, NY 11788 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $1K | $1K | 5.86% |
| ARCHON LLC3 | 225 WIRELESS BLVD HAUPPAUGE, NY 11788 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $904 | $904 | 4.16% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | PO BOX 1788 GRAND RAPIDS, MI 49501 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | — | $1K | 11.80% |
| PROFESSIONAL GROUP PLANS INC3 | 225 WIRELESS BLVD #308 HAUPPAUGE, NY 11788 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $707 | $707 | 5.82% |
| ARCHON LLC3 | 225 WIRELESS BLVD HAUPPAUGE, NY 11788 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $507 | $507 | 4.17% |
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 | 206 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 11 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 217 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 246 | $3.4M |
| Dental | DELTA DENTAL OF CALIFORNIA | 339 | $151K |
| Vision | VISION SERVICE PLAN | 128 | $28K |
| Life insurance(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 144 | $50K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 144 | $12K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 144 | $38K |
| Prescription drug | CALIFORNIA PHYSICIANS' SERVICE | 246 | $2.7M |
| Other(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 144 | $50K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 339 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.