| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 601 UNIVERSITY AVE, SUITE 250 SACRAMENTO, CA 95825 | CALIFORNIA CHOICE | $57K | — | $57K | 5.00% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 601 UNIVERSITY AVENUE SUITE 250 SACRAMENTO, CA 95825 | HUMANA INSURANCE COMPANY | $8K | $3K | $10K | 6.91% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | DBA BENEFITS DONE RIGHT INS AGY LLC SACRAMENTO, CA 95825 | AMERICAN FIDELITY ASSURANCE COMPANY | $10K | — | $10K | 22.34% |
| CHIMIENTI & ASSOCIATES3 Filed as: CHIMIENTI & ASSOC INS SVC | 3400 W MINERAL KING #B VISALIA, CA 93291 | AMERICAN FIDELITY ASSURANCE COMPANY | $2K | — | $2K | 4.34% |
| BULLION, BARBARA3 Filed as: BULLION, BARBARA A | 3486 E BOOT TRACK TR GILBERT, AZ 85296 | AMERICAN FIDELITY ASSURANCE COMPANY | $1K | — | $1K | 2.59% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | PO BOX 1788 GRAND RAPIDS, MI 49501 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $376 | $3K | 16.59% |
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 | 127 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 127 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA CHOICE | 109 | $1.2M |
| Dental | HUMANA INSURANCE COMPANY | 139 | $150K |
| Vision | HUMANA INSURANCE COMPANY | 139 | $150K |
| Life insurance | HUMANA INSURANCE COMPANY | 139 | $150K |
| Short-term disability | AMERICAN FIDELITY ASSURANCE COMPANY | 93 | $45K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 35 | $20K |
| Other(2 contracts, 2 carriers) | HUMANA INSURANCE COMPANY | 139 | $196K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 139 | — |
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.