| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | PO BOX 1788 GRAND RAPIDS, MI 49501 | BLUE CROSS OF CALIFORNIA | $33K | — | $33K | 4.13% |
| E LEE & ASSOCIATES INC.3 Filed as: E LEE & ASSOCIATES INC | 16835 W BERNARDO DR, #212 SAN DIEGO, CA 92127 | BLUE CROSS OF CALIFORNIA | — | $3K | $3K | 0.33% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 28202 CABOT ROAD, STE 600 LAGUNA NIGUEL, CA 92677 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $4K | — | $4K | 9.92% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 16835 W BERNARDO DR STE 212 SAN DIEGO, CA 92127 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $7 | $2K | 15.06% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LL | 16835 W BERNARDO DR STE 212 SAN DIEGO, CA 92127 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 15.00% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LL | 16835 W BERNARDO DR STE 212 SAN DIEGO, CA 92127 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $376 | — | $376 | 15.02% |
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 | 130 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 3 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 136 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 150 | $792K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 81 | $41K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 81 | $41K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 136 | $11K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 29 | $3K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 130 | $7K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 136 | $11K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 150 | — |
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.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.