| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3 POLARIS WAY 4TH FLOOR ALISO VIEJO, CA 92656 | BLUE OF CALIFORNIA | $7K | $244K | $251K | 4.23% |
| DAVID J DIMARIA3 | 130 N BRAND BLVD STE 310 GLENDALE, CA 91203 | BLUE OF CALIFORNIA | $124K | — | $124K | 2.08% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3 POLARIS WAY STE 400 ALISO VIEJO, CA 92656 | METROPOLITAN LIFE INSURANCE COMPANY | $52K | — | $52K | 9.87% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFIT GRP INC | 5110 N 40TH ST STE 234 PHOENIZ, AZ 85018 | METROPOLITAN LIFE INSURANCE COMPANY | $7K | $6K | $13K | 2.43% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 9655 GRANITE RIDGE DR STE 500 SAN DIEGO, CA 92123 | METROPOLITAN LIFE INSURANCE COMPANY | — | $5K | $5K | 0.96% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC DB | STE 140 3130 S HARBOR BLVD SANTA ANA, CA 92704 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $13K | $5K | $18K | 4.65% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 3130 HARBOR BLVD STE 140 SANTA ANA, CA 92704 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | — | $6K | 11.11% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | STE 140 3130 S HARBOR BLVD SANTA ANA, CA 92704 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $431 | $6K | 16.21% |
| FLAHERTY, BARBARA A3 | STE 101 444 N LARCHMONT BLVD LOS ANGELES, CA 90004 | UNUM LIFE INSURANCE COMPANY OF AMERICA | -$3K | — | -$3K | -8.46% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3 POLARIS WAY STE 400 ALISO VIEJO, CA 92656 | METROPOLITAN LIFE INSURANCE COMPANY | $7K | — | $7K | 23.55% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFIT GRP INC | 5110 N 40TH ST STE 234 PHOENIX, AZ 85018 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $448 | $2K | 7.35% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 9655 GRANITE RIDGE DR STE 500 SAN DIEGO, CA 92123 | METROPOLITAN LIFE INSURANCE COMPANY | — | $290 | $290 | 0.94% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3 POLARIS WAY STE 400 ALISO VIEJO, CA 92656 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | — | $6K | 22.63% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFIT GRP INC | 5110 N 40TH ST STE 234 PHOENIX, AZ 85018 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | $365 | $2K | 7.11% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 9655 GRANITE RIDGE DR STE 500 SAN DIEGO, CA 92123 | METROPOLITAN LIFE INSURANCE COMPANY | — | $238 | $238 | 0.95% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 3130 S HARBOR BLVD STE 140 SANTA ANA, CA 92704 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $898 | — | $898 | 18.61% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC DB | STE 140 3130 S HARBOR BLVD SANTA ANA, CA 92704 | FIRST UNUM LIFE INSURANCE COMPANY | $261 | $21 | $282 | 16.21% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 3130 S HARBOR BLVD STE 140 SANTA ANA, CA 92704 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $107 | — | $107 | 19.93% |
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 | 269 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 271 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | BLUE OF CALIFORNIA | 780 | $6.0M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 659 | $525K |
| Vision | BLUE OF CALIFORNIA | 780 | $5.9M |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 262 | $423K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 262 | $388K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 262 | $388K |
| Prescription drug | BLUE OF CALIFORNIA | 780 | $5.9M |
| Other(6 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 264 | $488K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 780 | — |
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.