| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA | 3 POLARIS WAY ALISO VIEJO, CA 92656 | UNITED HEALTHCARE INSURANCE COMPANY | $35K | — | $35K | 3.05% |
| CMR RISK & INSURANCE SERVICES, INC.3 Filed as: CMR RISK | 110 W A STREET SAN DIEGO, CA 92101 | UNITED HEALTHCARE INSURANCE COMPANY | $27K | — | $27K | 2.38% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFIT GROUP | 5110 N. 40TH STREET PHOENIZ, AZ 85018 | UNITED HEALTHCARE INSURANCE COMPANY | $14K | $2K | $16K | 1.41% |
| J.S. TUCKER INSURANCE SERVICES3 | 3827 MEGAN LANE ENCINITAS, CA 92024 | MEDIEXCEL HEALTH PLAN | $11K | — | $11K | 3.00% |
| CMR RISK & INSURANCE SERVICES, INC.3 Filed as: CMR RISK | 8880 RIO SAN DIEGO SAN DIEGO, CA 92108 | MEDIEXCEL HEALTH PLAN | $8K | — | $8K | 2.07% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3130 S. HARBOR BLVD. SANTA ANA, CA 92704 | MEDIEXCEL HEALTH PLAN | $3K | — | $3K | 0.80% |
| CMR RISK & INSURANCE SERVICES, INC.3 Filed as: CMR RISK | 110 W A STREET SAN DIEGO, CA 92101 | UNITED HEALTHCARE INSURANCE COMPANY | $4K | — | $4K | 6.74% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA | P.O. BOX 1788 GRAND RAPIDS, MI 49501 | UNITED HEALTHCARE INSURANCE COMPANY | $2K | — | $2K | 3.19% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFIT GROUP | 5110 N. 40TH STREET PHOENIZ, AZ 85018 | UNITED HEALTHCARE INSURANCE COMPANY | $924 | — | $924 | 1.59% |
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 | 295 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 299 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 363 | $1.5M |
| Dental | UNITED HEALTHCARE INSURANCE COMPANY | 363 | $1.1M |
| Vision | UNITED HEALTHCARE INSURANCE COMPANY | 363 | $1.1M |
| Life insurance | UNITED HEALTHCARE INSURANCE COMPANY | 295 | $58K |
| Prescription drug(2 contracts, 2 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 363 | $1.5M |
| Other | UNITED HEALTHCARE INSURANCE COMPANY | 295 | $58K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 363 | — |
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.