| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENEFITS PLANNING SERVICE3 | 1200 QUAIL ST SUITE 105 NEWPORT BEACH, CA 92660 | AETNA HEALTH, INC. | $16K | — | $16K | 1.54% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INSURANCE | PO BOX 19763 1920 MAIN ST, SUITE 600 IRVINE, CA 92623 | AETNA HEALTH, INC. | $5K | — | $5K | 0.45% |
| BENEFITS PLANNING SERVICE3 | 1200 QUAIL ST SUITE 105 NEWPORT BEACH, CA 92660 | AETNA LIFE INSURANCE CO | $3K | — | $3K | 1.51% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INSURANCE | PO BOX 19763 1920 MAIN ST, SUITE 600 IRVINE, CA 92623 | AETNA LIFE INSURANCE CO | $972 | — | $972 | 0.44% |
| BENEFITS PLANNING SERVICE3 | 1200 QUAIL ST SUITE 105 NEWPORT BEACH, CA 92660 | THE LINCOLN NATIONAL LIFE INS CO | $4K | — | $4K | 8.81% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE | 1920 MAIN STREET SUITE 600 IRVINE, CA 92614 | THE LINCOLN NATIONAL LIFE INS CO | $602 | — | $602 | 1.19% |
| BENEFITS PLANNING SERVICE3 | 1200 QUAIL ST SUITE 105 NEWPORT BEACH, CA 92660 | VISION SERVICE PLAN | $2K | — | $2K | 8.83% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS | 1920 MAIN ST SUITE 600 IRVINE, CA 92614 | VISION SERVICE PLAN | $276 | — | $276 | 1.17% |
| BENEFITS PLANNING SERVICE3 | 1200 QUAIL ST SUITE 105 NEWPORT BEACH, CA 92660 | UDC DENTAL OF CALIFORNIA, INC. | $1K | — | $1K | 9.00% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS SVCS LLC | 1920 MAIN ST SUITE 600 IRVINE, CA 92614 | UDC DENTAL OF CALIFORNIA, INC. | $144 | — | $144 | 0.99% |
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 | 303 | 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. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 303 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE CO | 52 | $223K |
| Dental | UDC DENTAL OF CALIFORNIA, INC. | 72 | $14K |
| Vision | VISION SERVICE PLAN | 183 | $24K |
| Life insurance | THE LINCOLN NATIONAL LIFE INS CO | 296 | $50K |
| Other | THE LINCOLN NATIONAL LIFE INS CO | 296 | $50K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 303 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.