| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 100 OTTAWA AVE. GRAND RAPIDS, MI 49503 | AETNA HEALTH, INC. | $55K | — | $55K | 4.83% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 100 OTTAWA AVE. GRAND RAPIDS, MI 49503 | AETNA LIFE INSURANCE COMPANY | $19K | — | $19K | 4.88% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | METROPOLITAN LIFE INSURANCE COMPANY | $10K | $69 | $10K | 10.39% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DRIVE URBANDALE, IA 50323 | METROPOLITAN LIFE INSURANCE COMPANY | $356 | — | $356 | 0.36% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 23716 BIRTCHER DRIVE LAKE FOREST, CA 92630 | SAFEGUARD HEALTH PLANS, INC. | $1K | $8 | $1K | 10.16% |
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 | 184 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 185 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA HEALTH, INC. | 208 | $1.5M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 315 | $110K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 315 | $100K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 315 | $100K |
| Prescription drug(2 contracts, 2 carriers) | AETNA HEALTH, INC. | 208 | $1.5M |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 315 | $100K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 315 | — |
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.