| 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 | UNITED HEALTHCARE INSURANCE COMPANY | $63K | — | $63K | 5.06% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | METROPOLITAN LIFE INSURANCE COMPANY | — | $20 | $20 | 0.02% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 2010 MAIN STREET, SUITE 700 IRVINE, CA 92614 | CONTINENTAL AMERICAN INSURACNE COMPANY | $4K | — | $4K | 21.87% |
| KENNETH G. BARCLAY3 Filed as: KENNETH G BARCLAY | 1218 VIA CANDELAS OCEANSIDE, CA 92056 | CONTINENTAL AMERICAN INSURACNE COMPANY | $3K | — | $3K | 19.72% |
| JONATHAN ALI HAJIMOMEN3 Filed as: JONATHAN A HAJIMOMEN | 654 GRAND MANAN CYORESS, CA 90630 | CONTINENTAL AMERICAN INSURACNE COMPANY | $2K | — | $2K | 11.38% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 2010 MAIN STREET, SUITE 1050 IRVINE, CA 92614 | VISION SERVICE PLAN | $863 | — | $863 | 6.53% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 2010 MAIN STREET, SUITE 700 IRVINE, CA 92614 | AETNA INTERNATIONAL | $300 | — | $300 | 30.00% |
| VARIOUS - SEE ATTACHED3 Filed as: AFLAC - SEE ATTACHMENT | 1932 WYNNTON ROAD COLUMBUS, GA 31999 | AFLAC | $32 | — | $32 | 8.89% |
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 | 99 | 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) | 99 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 150 | $1.3M |
| Dental | SAFEGUARD HEALTH PLAN INC | 50 | $5K |
| Vision | VISION SERVICE PLAN | 89 | $13K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 269 | $88K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 269 | $88K |
| Prescription drug(2 contracts, 2 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 150 | $1.3M |
| Other(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 269 | $106K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 269 | — |
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.