| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 9655 GRANITE RIDGE DRIVE, SUITE 500 SAN DIEGO, CA 92123 | BLUE OF CALIFORNIA -CALIFORNIA PHYSICIAN'S SERVICE | — | $61K | $61K | 5.28% |
| MEDVE, MELISSA D3 | 11555 SORRENTO VALLEY RD 203 SAN DIEGO, CA 92121 | BLUE OF CALIFORNIA -CALIFORNIA PHYSICIAN'S SERVICE | $24K | — | $24K | 2.11% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | — | UNITED CONCORDIA INSURANCE COMPANY | $8K | — | $8K | 10.02% |
| ACRISURE LLC3 | 990 HIGHLAND DR STE 110C SOLANA BEACH, CA 92075 | AMERITAS LIFE INSURANCE CORP | $2K | — | $2K | 10.00% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 990 HIGHLAND DR SUITE 110 C SOLANA BEACH, CA 92075 | HUMANA INSURANCE COMPANY | $2K | — | $2K | 15.02% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 9655 GRANITE RIDGE DRIVE, SUITE 500 SAN DIEGO, CA 92123 | BLUE SHIELD OF CALIFORNIA LIFE HEALTH INSURANCE COMPANY | $1K | — | $1K | 10.00% |
| MEDVE, MELISSA D3 | 11555 SORRENTO VALLEY RD 203 SAN DIEGO, CA 92121 | BLUE SHIELD OF CALIFORNIA LIFE HEALTH INSURANCE COMPANY | $241 | — | $241 | 2.00% |
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 | 151 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 151 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE OF CALIFORNIA -CALIFORNIA PHYSICIAN'S SERVICE | 195 | $1.2M |
| Dental(2 contracts, 2 carriers) | BLUE OF CALIFORNIA -CALIFORNIA PHYSICIAN'S SERVICE | 240 | $1.2M |
| Vision | AMERITAS LIFE INSURANCE CORP | 288 | $16K |
| Life insurance(2 contracts, 2 carriers) | HUMANA INSURANCE COMPANY | 166 | $26K |
| Other(2 contracts, 2 carriers) | HUMANA INSURANCE COMPANY | 166 | $26K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 288 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.