| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | PO BOX 1788 GRAND RAPIDS, MI 49501 | AETNA HEALTH, INC. | $41K | — | $41K | 5.16% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | PO BOX 1788 GRAND RAPIDS, MI 49501 | AETNA LIFE INSURANCE CO. | $7K | — | $7K | 7.18% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | STE 212 16835 W BERNARDO DRIVE SAN DIEGO, CA 92127 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $129 | $3K | 15.75% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LL | 9655 GRANITE RIDGE DR #500 SAN DIEGO, CA 92123 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 9.26% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LL | 9655 GRANITE RIDGE DR #500 SAN DIEGO, CA 92123 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $461 | — | $461 | 9.66% |
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 | 125 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 129 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE CO. | 167 | $96K |
| Dental | AETNA LIFE INSURANCE CO. | 167 | $96K |
| Vision | AETNA LIFE INSURANCE CO. | 167 | $96K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 139 | $17K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 30 | $5K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 131 | $12K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 139 | $17K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 180 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.