| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 5664 PRAIRIE CREEK DR SE CALEDONIA, MI 49316 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $48K | $723 | $49K | 5.40% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 5664 PRAIRIE CREEK DR. CALDEDONIA, MI 49316 | KAISER FOUNDATION HEALTH PLAN INC | $16K | — | $16K | 4.96% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 16835 W BERNARDO DR STE 212 SAN DIEGO, CA 92127 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | — | $6K | 15.00% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 16835 E BERNARDO DR STE 212 SAN DIEGO, CA 92127 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | — | $5K | 15.00% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 16835 W BERNARDO STE 212 SAN DIEGO, CA 92127 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $245 | — | $245 | 2.60% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 16835 W BERNARDO DR STE 212 SAN DIEGO, CA 92127 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 15.00% |
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 | 117 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 120 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 191 | $1.2M |
| Dental | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 191 | $899K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 118 | $41K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 118 | $35K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 118 | $7K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 191 | — |
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.