| 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 | $62K | — | $62K | 4.97% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | DBA BENEFITS DONE RIGHT 601 UNIVERSITY AVE STE 250 SACRAMENTO, CA 95825 | PRINCIPAL LIFE INSURANCE COMPANY | $13K | — | $13K | 7.79% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | DBA PROCO INSURANCE 910 E HAMILTON AVE STE 410 CAMPBELL, CA 95008 | PRINCIPAL LIFE INSURANCE COMPANY | — | $9K | $9K | 5.35% |
| BENEFITS MATCHMAKING LLC3 Filed as: BENEFITS MATCHMAKING, LLC | DBA SUVAUN 100 OTTAWA AVE SW GRAND RAPIDS MI, MI 49503 | PRINCIPAL LIFE INSURANCE COMPANY | $7K | — | $7K | 3.90% |
| ACRISURE LLC3 | PO BOX 1788 GRAND RAPIDS, MI 49501 | PRINCIPAL LIFE INSURANCE COMPANY | — | $5K | $5K | 2.69% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | DBA BENEFITS DONE RIGHT INS AGY LLC SACRAMENTO, CA 95825 | AMERICAN FIDELITY ASSURANCE COMPANY | $10K | — | $10K | 22.04% |
| BULLION, BARBARA3 Filed as: BULLION, BARBARA A | 3486 E BOOT TRACK TR GILBERT, AZ 85296 | AMERICAN FIDELITY ASSURANCE COMPANY | $780 | — | $780 | 1.72% |
| CHIMIENTI & ASSOCIATES3 Filed as: CHIMIENTI & ASSOC INS SVC | 3400 W MINERAL KING #B VISALIA, CA 93291 | AMERICAN FIDELITY ASSURANCE COMPANY | $597 | — | $597 | 1.32% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | DBA PACIFIC DIVERSIFIED INS SERV MORGAN HILL, CA 95037 | AMERICAN FIDELITY ASSURANCE COMPANY | $12 | — | $12 | 0.03% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | PO BOX 1788 GRAND RAPIDS, MI 49501 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $196 | $4K | 15.38% |
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 | 151 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 155 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA CHOICE | 117 | $1.3M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 288 | $169K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 288 | $169K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 288 | $169K |
| Short-term disability | AMERICAN FIDELITY ASSURANCE COMPANY | 101 | $45K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 44 | $27K |
| Other | AMERICAN FIDELITY ASSURANCE COMPANY | 101 | $45K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 288 | — |
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.