| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3130 S HARBOR BLVD STE 140 SANTA ANA, CA 92704 | KAISER FOUNDATION HEALTH PLAN INC | $49K | — | $49K | 3.82% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3 POLARIS WAY 4TH FL ALISO VIEJO, CA 92656 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $34K | — | $34K | 9.93% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3130 S HARBOR BLVD STE 140 SANTA ANA, CA 92704 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | — | $6K | 9.05% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 9655 GRANITE RIDGE DR STE 500 SAN DIEGO, CA 92123 | METROPOLITAN LIFE INSURANCE COMPANY | — | $659 | $659 | 0.96% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3 POLARIS WAY 4TH FL ALISO VIEJO, CA 92656 | CIGNA DENTAL HEALTH OF CALIFORNIA, INC. | $3K | — | $3K | 10.00% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3 POLARIS WAY 4TH FL ALISO VIEJO, CA 92656 | CIGNA DENTAL HEALTH OF ILLINOIS, INC. | $303 | — | $303 | 9.98% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3 POLARIS WAY 4TH FL ALISO VIEJO, CA 92656 | CIGNA DENTAL HEATH OF TEXAS, INC. | $254 | — | $254 | 10.00% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3 POLARIS WAY 4TH FL ALISO VIEJO, CA 92656 | CIGNA DENTAL HEALTH OF FLORIDA, INC. | $234 | — | $234 | 9.99% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3 POLARIS WAY 4TH FL ALISO VIEJO, CA 92656 | CIGNA DENTAL HEALTH PLAN OF ARIZONA, INC. | $106 | — | $106 | 10.04% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3 POLARIS WAY 4TH FL ALISO VIEJO, CA 92656 | CIGNA DENTAL HEALTH OF MARYLAND, INC. | $102 | — | $102 | 9.97% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3 POLARIS WAY 4TH FL ALISO VIEJO, CA 92656 | CIGNA DENTAL HEALTH OF NEW JERSEY, INC. | $92 | — | $92 | 9.96% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3 POLARIS WAY 4TH FL ALISO VIEJO, CA 92656 | CIGNA DENTAL HEALTH OF KANSAS, INC. | $56 | — | $56 | 9.98% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3 POLARIS WAY 4TH FL ALISO VIEJO, CA 92656 | CIGNA DENTAL HEALTH OF PENNSYLVANIA, INC. | $40 | — | $40 | 10.10% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALFORNIA LLC | 3 POLARIS WAY 4TH FL ALISO VIEJO, CA 92656 | CIGNA DENTAL HEALTH OF NORTH CAROLINA, INC. | $20 | — | $20 | 10.10% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3 POLARIS WAY 4TH FL ALISO VIEJO, CA 92656 | CIGNA DENTAL HEALTH OF VIRGINIA, INC. | $20 | — | $20 | 10.10% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3 POLARIS WAY 4TH FL ALISO VIEJO, CA 92656 | CIGNA DENTAL HEALTH OF OHIO, INC | $7 | — | $7 | 10.61% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3 POLARIS WAY 4TH FL ALISO VIEJO, CA 92656 | CIGNA DENTAL HEALTH OF COLORADO, INC. | $7 | — | $7 | 10.61% |
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 | 1,360 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,361 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 211 | $1.5M |
| Dental(14 contracts, 14 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 462 | $378K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 756 | $69K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 756 | $69K |
| Other(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 756 | $407K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 756 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.