| 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 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $128K | — | $128K | 10.47% |
| SYNERGY ENROLLMENT AND BENEFITS LLC3 Filed as: SYNERGY ENROLLMENT & BENEFITS | 9370 SKY PARK COURT SUITE 250 SAN DIEGO, CA 92123 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $15K | — | $15K | 1.24% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 5664 PRAIRIE CREEK DRIVE SE CALEDONIA, MI 49316 | SIMNSA | $32K | — | $32K | 7.00% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC DBA | ELT INSURANCE SERVICES 5664 PRAIRIE CREEK DRIVE CALEDONIA, MI 49316 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $5K | — | $5K | 3.34% |
| ELT INSURANCE SERVICES3 | 16835 W BERNARDO DR SAN DIEGO, CA 92127 | HARTFORD ACCIDENT AND LIFE INSURANCE COMPANY | $951 | — | $951 | 6.44% |
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 | 1,065 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,068 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | SIMNSA | 181 | $628K |
| Dental(2 contracts, 2 carriers) | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,141 | $1.7M |
| Vision | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,141 | $1.2M |
| Life insurance | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,141 | $1.2M |
| Short-term disability | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,141 | $1.2M |
| Long-term disability | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,141 | $1.2M |
| Other | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,141 | $1.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,141 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.