| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | AETNA HEALTH OF CALIFORNIA INC. | $83K | — | $83K | 3.59% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | UNITEDHEALTHCARE INSURANCE COMPANY | $47K | — | $47K | 3.98% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | AETNA LIFE INSURANCE COMPANY | $10K | — | $10K | 3.98% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | CAPITAL ADVANTAGE ASSURANCE COMPANY | $31K | — | $31K | 18.99% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $15K | — | $15K | 10.00% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | UNION SECURITY INSURANCE COMPANY | $8K | — | $8K | 6.00% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | VISION SERVICE PLAN | $2K | — | $2K | 4.18% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | UDC DENTAL OF CALIFORNIA, INC. | $3K | — | $3K | 10.02% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 10.00% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 10.00% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 10.00% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | AEGIS SECURITY INSURANCE COMPANY | $812 | — | $812 | 7.00% |
| CONSOLIDATED BENEFITS INC3 Filed as: CONSOLIDATED BENEFITS INC. | 2500 ELMERTON AVENUE HARRISBURG, PA 17110 | AEGIS SECURITY INSURANCE COMPANY | $464 | — | $464 | 4.00% |
| AEGIS GENERAL INSURANCE AGENCY3 Filed as: AEGIS GENERAL INS AGENCY INC. | 2407 PARK DRIVE HARRISBURG, PA 17110 | AEGIS SECURITY INSURANCE COMPANY | $150 | — | $150 | 1.29% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | UNITED CONCORDIA LIFE AND HEALTH INSURANCE COMPANY | $910 | — | $910 | 9.79% |
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 | 401 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 11 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 412 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | AETNA HEALTH OF CALIFORNIA INC. | 555 | $3.9M |
| Dental(5 contracts, 5 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 258 | $1.5M |
| Vision(2 contracts, 2 carriers) | CAPITAL ADVANTAGE ASSURANCE COMPANY | 361 | $202K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 492 | $150K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 118 | $23K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 151 | $29K |
| Prescription drug(4 contracts, 4 carriers) | AETNA HEALTH OF CALIFORNIA INC. | 555 | $3.9M |
| Other(4 contracts, 4 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 491 | $36K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 555 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.