| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INTERNATIONAL PROINSURANCE SERVICES3 | 3905 BOHANNON DR #B MENLO PARK, CA 94025 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $135K | $24K | $159K | 2.59% |
| EBS INSURANCE BROKERS3 | 1 GATEWAY CTR STE 650 NEWTON, MA 02458 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $122K | — | $122K | 1.99% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 2055 WOODSIDE RD STE 290 REDWOOD CITY, CA 94061 | FIRST UNUM LIFE INSURANCE COMPANY | $8K | $3K | $11K | 7.00% |
| EBS INSURANCE BROKERS3 | 1 GATEWAY CTR STE 650 NEWTON, MA 02458 | KAISER FOUNDATION HEALTH PLAN INC | $4K | — | $4K | 3.06% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 5664 PRAIRIE CREEK DR SE CALEDONIA, MI 49316 | KAISER FOUNDATION HEALTH PLAN INC | $746 | — | $746 | 0.65% |
| EBS INSURANCE BROKERS3 | 1 GATEWAY CTR STE 650 NEWTON, MA 02458 | VISION SERVICE PLAN | $1K | — | $1K | 1.68% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC DBA | PROCO INSURANCE SERVICE 2925 BOHANNIN DR, STE 100 MENLO PARK, CA 94025 | VISION SERVICE PLAN | $921 | — | $921 | 1.51% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 2055 WOODSIDE RD STE 290 REDWOOD CITY, CA 94061 | FIRST UNUM LIFE INSURANCE COMPANY | $1K | $158 | $2K | 13.51% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 2055 WOODSIDE RD STE 290 REDWOOD CITY, CA 94061 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $264 | — | $264 | 5.11% |
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 | 624 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 624 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 1,138 | $6.3M |
| Vision | VISION SERVICE PLAN | 524 | $61K |
| Life insurance | FIRST UNUM LIFE INSURANCE COMPANY | 624 | $162K |
| Long-term disability | FIRST UNUM LIFE INSURANCE COMPANY | 624 | $162K |
| Prescription drug(2 contracts, 2 carriers) | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 1,138 | $6.3M |
| Other(3 contracts, 2 carriers) | FIRST UNUM LIFE INSURANCE COMPANY | 624 | $179K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,138 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.