| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | KAISER FOUNDATION HEALTH PLAN INC. | $5K | $2 | $5K | 7.83% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | METROPOLITAN LIFE INSURANCE COMPANY | $933 | $764 | $2K | 4.13% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 1120 BRISTOL STREET COSTA MESA, CA 92626 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | — | $2K | 4.09% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | HARTFORD LIFE AND ACCIDENT | $3K | — | $3K | 15.01% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 1120 BRISTOL STREET COSTA MESA, CA 92626 | HARTFORD LIFE AND ACCIDENT | -$1 | $242 | $241 | 1.27% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 1120 BRISTOL STREET COSTA MESA, CA 92626 | SAFEGUARD HEALTH PLANS, INC. | $459 | — | $459 | 3.72% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | SAFEGUARD HEALTH PLANS, INC. | $248 | $198 | $446 | 3.62% |
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 | 168 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 169 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC. | 134 | $62K |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 118 | $53K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 118 | $41K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 157 | $19K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC. | 134 | $62K |
| Other | HARTFORD LIFE AND ACCIDENT | 157 | $19K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 157 | — |
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.