| 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 | $27K | — | $27K | 4.10% |
| LEE SCHEUER3 | 3925 BOHANNON DR SUITE 100 MENLO PARK, CA 94025 | KAISER FOUNDATION HEALTH PLAN OF COLORADO | $15K | — | $15K | 3.49% |
| THE BOON INSURANCE AGENCY3 | 6300 BRIDGEPOINT PARKWAY AUSTIN, TX 78730 | AETNA LIFE INSURANCE COMPANY | $18K | — | $18K | 11.00% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC DBA | PROCO 5664 PRAIRIE CREEK DR. CALEDONIA, MI 49316 | AETNA LIFE INSURANCE COMPANY | $10K | — | $10K | 6.00% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 2055 WOODSIDE RD STE 290 REDWOOD CITY, CA 94061 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $12K | — | $12K | 10.00% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 5664 PRAIRIE CREEK DR SE CALEDONIA, MI 49316 | KAISER FOUNDATION HEALTH PLAN INC | $3K | — | $3K | 4.29% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 2055 WOODSIDE RD STE 290 REDWOOD CITY, CA 94061 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | — | $5K | 10.00% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 2055 WOODSIDE RD STE 290 REDWOOD CITY, CA 94061 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 10.00% |
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 | 955 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 10 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 965 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 99 | $1.3M |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 955 | $52K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 955 | $122K |
| Other(2 contracts, 2 carriers) | MODERN LIFE INC. | 955 | $154K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 955 | — |
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.