| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | PO BOX 1788 GRAND RAPIDS, MI 49501 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $82K | — | $82K | 1.88% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 5664 PRAIRIE CREEK DR CALEDONIA, MI 49316 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $47K | — | $47K | 1.07% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | D/B/A AHERN INSURANCE BROKERAGE L 9655 GRANITE RIDGE DR STE 500 SAN DIEGO, CA 921232676 | METROPOLITAN LIFE INSURANCE COMPANY | $38K | $4K | $42K | 8.84% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA,LLC/JS TUCKE | — | SIMNSA | $21K | — | $21K | 7.00% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LL | 16835 W BERNARDO DR STE 212 SAN DIEGO, CA 92127 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $15K | — | $15K | 12.00% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LL | 16835 W BERNARDO DR STE 212 SAN DIEGO, CA 92127 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | — | $4K | 12.00% |
| BRIAN W PATTEN3 | 102 PEPPERGRASS RD BADEN, PA 150052564 | RELIASTAR LIFE INSURANCE COMPANY | $5K | — | $5K | 18.27% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 3631 S HARBOR BLVD STE 200 SANTA ANA, CA 927047936 | RELIASTAR LIFE INSURANCE COMPANY | $5K | — | $5K | 18.27% |
| ELT INSURANCE SERVICES3 | — | MONUMENTAL LIFE INSURANCE COMPANY | $943 | — | $943 | 6.39% |
| LEAVITT GROUP3 Filed as: SCOTT A LEAVITT | — | MONUMENTAL LIFE INSURANCE COMPANY | $193 | — | $193 | 1.31% |
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 | 909 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 10 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 919 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 867 | $4.7M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 1,642 | $773K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 1,642 | $477K |
| Life insurance | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 867 | $4.3M |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 697 | $34K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 712 | $127K |
| Other | RELIASTAR LIFE INSURANCE COMPANY | 55 | $27K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,642 | — |
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."
No prospect flags tripped on this filing.