| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3130 S. HARBOR BLVD SUITE 140 AND 150 SANTA ANA, CA 92704 | BLUE OF CALIFORNIA | $7K | $254K | $261K | 4.23% |
| DAVID J DIMARIA3 | 130 N BRAND BLVD STE 310 GLENDALE, CA 91203 | BLUE OF CALIFORNIA | $129K | — | $129K | 2.08% |
| 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 | 3.29% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3130 S HARBOR BLVD STE 140 SANTA ANA, CA 92704 | METROPOLITAN LIFE INSURANCE COMPANY | $50K | — | $50K | 9.97% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFIT GRP INC | 5110 N 40TH ST, STE 234 PHOENIX, AZ 85018 | METROPOLITAN LIFE INSURANCE COMPANY | $7K | — | $7K | 1.29% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 9655 GRANITE RIDGE DR STE 500 SAN DIEGO, CA 92123 | METROPOLITAN LIFE INSURANCE COMPANY | — | $5K | $5K | 0.92% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 3130 HARBOR BLVD STE 140 SANTA ANA, CA 92704 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $14K | — | $14K | 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 | $5K | $227 | $5K | 15.75% |
| FLAHERTY, BARBARA A3 | 444 N LARCHMONT BLVD STE 101 LOS ANGELES, CA 90004 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 3.40% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3130 S HARBOR BLVD STE 140 SANTA ANA, CA 92704 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | — | $5K | 21.49% |
| ROGERS BENEFIT GROUP INC3 | 5110 N 40TH ST STE 234 PHOENIX, AZ 85018 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | — | $1K | 5.37% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 9655 GRANITE RIDGE DR STE 500 SAN DIEGO, CA 92123 | METROPOLITAN LIFE INSURANCE COMPANY | — | $202 | $202 | 0.90% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 3130 S HARBOR BLVD STE 140 SANTA ANA, CA 92704 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 20.00% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC DBA | 3130 S HARBOR STE 140 SANTA ANA, CA 92704 | FIRST UNUM LIFE INSURANCE COMPANY | $295 | $15 | $310 | 15.76% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 3130 S HARBOR BLVD STE 140 SANTA ANA, CA 92704 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $104 | — | $104 | 19.92% |
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 | 286 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 289 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE OF CALIFORNIA | 800 | $6.2M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 680 | $506K |
| Vision | BLUE OF CALIFORNIA | 800 | $6.2M |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 286 | $620K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 286 | $590K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 286 | $590K |
| Prescription drug | BLUE OF CALIFORNIA | 800 | $6.2M |
| Other(6 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 287 | $699K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 800 | — |
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.