| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 5330 CARROLL CANYON ROAD SUITE 110 SAN DIEGO, CA 92121 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $47K | — | $47K | 5.00% |
| ROGERS BENEFIT GROUP INC3 | 5110 N 40TH STREET SUITE 234 PHOENIX, AZ 85018 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | — | $19K | $19K | 2.00% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | DBA JS TUCKER INSURANCE 5330 CARROLL CANYON RD STE 110 SAN DIEGO, CA 92121 | PRINCIPAL LIFE INSURANCE COMPANY | $17K | — | $17K | 17.10% |
| ROGERS BENEFIT GROUP INC3 | 9909 MIRA MESA BLVD STE 160 SAN DIEGO, CA 92131 | PRINCIPAL LIFE INSURANCE COMPANY | $5K | $2K | $7K | 7.01% |
| ACRISURE LLC3 | PO BOX 1788 GRAND RAPIDS, MI 49501 | PRINCIPAL LIFE INSURANCE COMPANY | — | $514 | $514 | 0.51% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | DBA BENEFITS DONE RIGHT 601 UNIVERSITY AVE STE 250 SACRAMENTO, CA 95825 | PRINCIPAL LIFE INSURANCE COMPANY | — | $463 | $463 | 0.46% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | DBA THE LBL INSURANCE 3 POLARIS WAY FL 4 ALISO VIEJO, CA 92656 | PRINCIPAL LIFE INSURANCE COMPANY | -$8K | — | -$8K | -8.15% |
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 | 123 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 123 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 112 | $943K |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 202 | $101K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 202 | $101K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 202 | $101K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 202 | — |
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.