| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 5664 PRAIRIE CREEK DR CALEDONIA, MI 49316 | BLUE OF CALIFORNIA | $6K | $246K | $252K | 4.27% |
| DAVID J DIMARIA3 | 130 N BRAND BLVD STE 310 GLENDALE, CA 91203 | BLUE OF CALIFORNIA | — | $123K | $123K | 2.08% |
| OBS INSURANCE SERVICES3 | 800 WILSHIRE BLVD STE 710 LOS ANGELES, CA 90017 | BLUE OF CALIFORNIA | — | — | $0 | 0.00% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC DBA | 3130 S HARBOR BLVD STE 140 SANTA ANA, CA 92704 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $15K | $5K | $20K | 3.51% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFIT GRP INC | 5110 N 40TH ST, STE 234 PHOENIX, AZ 85018 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | — | $5K | 1.39% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 9655 GRANITE RIDGE DR, STE 500 SAN DIEGO, CA 92123 | METROPOLITAN LIFE INSURANCE COMPANY | — | $5K | $5K | 1.22% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFIT GRP INC | 5110 N 40TH ST STE 234 PHOENIX, AZ 85018 | METROPOLITAN LIFE INSURANCE COMPANY | — | $159 | $159 | 0.04% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3631 S HARBOR BLVD STE 200 SANTA ANA, CA 92704 | METROPOLITAN LIFE INSURANCE COMPANY | — | — | $0 | 0.00% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 3130 HARBOR BLVD STE 140 SANTA ANA, CA 92704 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $16K | — | $16K | 20.57% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 3130 S HARBOR BLVD STE 140 SANTA ANA, CA 92704 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $180 | $4K | 16.16% |
| FLAHERTY, BARBARA A3 | 800 WILSHIRE BLVD STE 710 LOS ANGELES, CA 90017 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $934 | — | $934 | 4.00% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC DBA | 3130 S HARBOR STE 140 SANTA ANA, CA 92704 | FIRST UNUM LIFE INSURANCE COMPANY | $205 | $10 | $215 | 20.09% |
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 | 272 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 274 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE OF CALIFORNIA | 740 | $5.9M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 640 | $383K |
| Vision | BLUE OF CALIFORNIA | 740 | $5.9M |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 277 | $585K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 277 | $562K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 277 | $562K |
| Prescription drug | BLUE OF CALIFORNIA | 740 | $5.9M |
| Other(4 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 277 | $665K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 740 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.