| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | PO BOX 1788 GRAND RAPIDS, MI 49501 | AETNA HEALTH, INC. | $42K | — | $42K | 5.37% |
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE SERVICES, | LLC 1600 WEST HILLSDALE BLVD SUITE #201 SAN MATEO, CA 94402 | AETNA HEALTH, INC. | $9K | — | $9K | 1.10% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | PO BOX 1788 GRAND RAPIDS, MI 49501 | AETNA LIFE INSURANCE CO. | $9K | — | $9K | 5.25% |
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE SERVICES, | LLC 1600 WEST HILLSDALE BLVD SUITE #201 SAN MATEO, CA 94402 | AETNA LIFE INSURANCE CO. | $2K | — | $2K | 1.08% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3110 E GUASTI RD STE 500 ONTARIO, CA 917611228 | PRINCIPAL LIFE INSURANCE COMPANY | $11K | — | $11K | 8.07% |
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE SERVICES | 2 ENTERPRISE DR STE 204 SHELTON, CT 064844657 | PRINCIPAL LIFE INSURANCE COMPANY | — | $6K | $6K | 4.60% |
| ACRISURE LLC3 Filed as: ACRISURE SOUTHWEST PARTNERS INS | 4000 WESTERLY PL STE 110 NEWPORT BEACH, CA 926602347 | PRINCIPAL LIFE INSURANCE COMPANY | $3K | — | $3K | 2.58% |
| ACRISURE LLC3 | PO BOX 1788 GRAND RAPIDS, MI 495011788 | PRINCIPAL LIFE INSURANCE COMPANY | — | $783 | $783 | 0.60% |
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 | 140 | 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. |
| Total participants (= "Plan participants" tile) | 140 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE CO. | 27 | $179K |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 292 | $131K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 292 | $131K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 292 | $131K |
| Other | PRINCIPAL LIFE INSURANCE COMPANY | 292 | $131K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 292 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.