| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | BLUE OF CALIFORNIA | $6K | $233K | $239K | 3.87% |
| DAVID J DIMARIA3 | 130 N BRAND BLVD STE 310 GLENDALE, CA 91203 | BLUE OF CALIFORNIA | — | $128K | $128K | 2.08% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3130 S. HARBOR BLVD SUITE 140 AND 150 SANTA ANA, CA 92704 | BLUE OF CALIFORNIA | $538 | $22K | $22K | 0.36% |
| 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 | $4K | $19K | 3.31% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3130 S HARBOR BLVD STE 140 SANTA ANA, CA 92704 | METROPOLITAN LIFE INSURANCE COMPANY | $46K | — | $46K | 9.85% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFIT GRP INC | 5110 N 40TH ST, STE 234 PHOENIX, AZ 85018 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | — | $6K | 1.31% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 3130 HARBOR BLVD STE 140 SANTA ANA, CA 92704 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $15K | — | $15K | 20.00% |
| 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 | $177 | $4K | 15.75% |
| FLAHERTY, BARBARA A3 | 444 N LARCHMONT BLVD STE 101 LOS ANGELES, CA 90004 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $880 | — | $880 | 3.73% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3130 S HARBOR BLVD STE 140 SANTA ANA, CA 92704 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | — | $4K | 22.29% |
| ROGERS BENEFIT GROUP INC3 | 5110 N 40TH ST STE 234 PHOENIX, AZ 85018 | METROPOLITAN LIFE INSURANCE COMPANY | $936 | — | $936 | 4.90% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 9655 GRANITE RIDGE DR STE 500 SAN DIEGO, CA 92123 | METROPOLITAN LIFE INSURANCE COMPANY | — | $171 | $171 | 0.90% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC DBA | 3130 S HARBOR STE 140 SANTA ANA, CA 92704 | FIRST UNUM LIFE INSURANCE COMPANY | $274 | $14 | $288 | 15.75% |
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 | 278 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 280 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE OF CALIFORNIA | 771 | $6.2M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 663 | $468K |
| Vision | BLUE OF CALIFORNIA | 771 | $6.2M |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 277 | $611K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 277 | $587K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 277 | $587K |
| Prescription drug | BLUE OF CALIFORNIA | 771 | $6.2M |
| Other(4 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 291 | $688K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 771 | — |
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.