| 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 | $80K | — | $80K | 5.49% |
| 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 | $41K | — | $41K | 9.26% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3 POLARIS WAY STE 400 ALISO VIEJO, CA 92656 | METROPOLITAN LIFE INSURANCE COMPANY | $7K | — | $7K | 9.06% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 1615 MURRAY CANYON RD STE 1050 SAN DIEGO, CA 92108 | METROPOLITAN LIFE INSURANCE COMPANY | — | $895 | $895 | 1.13% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3130 S HARBOR BLVD STE 140 SANTA ANA, CA 92704 | KAISER FOUNDATION HEALTH PLAN INC | $3K | — | $3K | 5.67% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3 POLARIS WAY 4TH FL ALISO VIEJO, CA 92656 | CIGNA DENTAL HEALTH OF CALIFORNIA, INC. | $4K | — | $4K | 9.13% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 16835 W BERNARDO STE 212 SAN DIEGO, CA 92127 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $1K | — | $1K | 3.87% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3 POLARIS WAY 4TH FL ALISO VIEJO, CA 92656 | CIGNA DENTAL HEATH OF TEXAS, INC. | $336 | — | $336 | 9.14% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3 POLARIS WAY 4TH FL ALISO VIEJO, CA 92656 | CIGNA DENTAL HEALTH OF OHIO, INC | $129 | — | $129 | 9.10% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3 POLARIS WAY 4TH FL ALISO VIEJO, CA 92656 | CIGNA DENTAL HEALTH OF MARYLAND, INC. | $117 | — | $117 | 9.11% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3 POLARIS WAY 4TH FL ALISO VIEJO, CA 92656 | CIGNA DENTAL HEALTH OF FLORIDA, INC. | $97 | — | $97 | 9.13% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3 POLARIS WAY 4TH FL ALISO VIEJO, CA 92656 | CIGNA DENTAL HEALTH PLAN OF ARIZONA, INC. | $77 | — | $77 | 9.14% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALFORNIA LLC | 3 POLARIS WAY 4TH FL ALISO VIEJO, CA 92656 | CIGNA DENTAL HEALTH OF COLORADO, INC. | $36 | — | $36 | 9.02% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3 POLARIS WAY 4TH FL ALISO VIEJO, CA 92656 | CIGNA DENTAL HEALTH OF PENNSYLVANIA, INC. | $24 | — | $24 | 9.02% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3 POLARIS WAY 4TH FL ALISO VIEJO, CA 92656 | CIGNA DENTAL HEALTH OF ILLINOIS, INC. | $16 | — | $16 | 9.04% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3 POLARIS WAY 4TH FL ALISO VIEJO, CA 92656 | CIGNA DENTAL HEALTH OF MISSOURI, INC. | $8 | — | $8 | 8.99% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3 POLARIS WAY 4TH FL ALISO VIEJO, CA 92656 | CIGNA DENTAL HEALTH OF KANSAS, INC. | $4 | — | $4 | 9.09% |
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 | 586 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 587 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 196 | $1.5M |
| Dental(12 contracts, 12 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 391 | $489K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 1,305 | $79K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 1,305 | $79K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 1,305 | $79K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,305 | — |
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.