| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 5664 PRAIRIE CREEK DR SE CALEDONIA, MI 49316 | KAISER FOUNDATION HEALTH PLAN INC | $14K | — | $14K | 5.40% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 2055 WOODSIDE RD STE 290 REDWOOD CITY, CA 94061 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $5K | — | $5K | 3.75% |
| ACRISURE LLC3 | 1570 THE ALAMEDA #6310 SAN JOSE, CA 95126 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $1K | — | $1K | 0.91% |
| INTERNATIONAL PROINSURANCE SERVICES3 Filed as: INTERNATIONAL PROINSURANCE SERV LLC | 3925 BOHANNON DR, STE 100 MENLO PARK, CA 94025 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $350 | $630 | $980 | 0.75% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 5664 PRAIRIE CREEK DR SE CALEDONIA, MI 49316 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 7.14% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 5664 PRAIRIE CREEK DR SE CALEDONIA, MI 49316 | KAISER FOUNDATION HEALTH PLAN INC | $2K | — | $2K | 5.35% |
| ACRISURE LLC3 | 3925 BOHANNON DR STE 100 MENLO PARK, CA 94025 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 5.00% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3925 BOHANNON DR STE 100 MENLO PARK, CA 94025 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $283 | $2K | 11.41% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3925 BOHANNON DR. STE 100 MENLO PARK, CA 94025 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | $177 | $2K | 11.33% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3925 BOHANNON DR STE 100 MENLO PARK, CA 94025 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $422 | $56 | $478 | 11.34% |
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 | 341 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 343 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC | 53 | $287K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 277 | $131K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 310 | $36K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 367 | $13K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 193 | $26K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 367 | $20K |
| Prescription drug(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC | 53 | $287K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 367 | $4K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 367 | — |
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.