| 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 | KAISER FOUNDATION HEALTH PLAN INC. | $72K | — | $72K | 5.42% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | KAISER FOUNDATION HEALTH PLAN INC. | $36K | — | $36K | 4.55% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK GOULD & ASSOCIATES INC | 3800 N CENTRAL AVE., FLOOR 9 PHOENIX, AZ 85012 | UNITED HEALTHCARE INSURANCE COMPANY | $9K | — | $9K | 4.14% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | SUN LIFE ASSURANCE COMPANY OF CANADA | $9K | — | $9K | 8.62% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | STANDARD INSURANCE COMPANY | $3K | — | $3K | 4.88% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | VISION SERVICE PLAN | $1K | — | $1K | 5.13% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | STANDARD INSURANCE COMPANY | $716 | — | $716 | 11.38% |
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 | 296 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 298 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 264 | $2.3M |
| Dental | SUN LIFE ASSURANCE COMPANY OF CANADA | 136 | $105K |
| Vision | VISION SERVICE PLAN | 189 | $24K |
| Life insurance | STANDARD INSURANCE COMPANY | 296 | $69K |
| Short-term disability | STANDARD INSURANCE COMPANY | 26 | $6K |
| Prescription drug(3 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 264 | $2.3M |
| Other | STANDARD INSURANCE COMPANY | 296 | $69K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 296 | — |
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.