| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 2010 MAIN STREET, SUITE 700 IRVINE, CA 92614 | CALIFORNIA PHYSICIANS SERVICE | $105 | $127 | $232 | 0.01% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTISMONROE INS SVS | 2010 MAIN STREET, SUITE 700 IRVINE, CA 92614 | VISION SERVICE PLAN | $2K | — | $2K | 5.00% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 2010 MAIN STREET, SUITE 700 IRVINE, CA 92614 | UNUM INSURANCE COMPANY | $851 | — | $851 | 13.86% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 2010 MAIN STREET, SUITE 700 IRVINE, CA 92614 | UNUM INSURANCE COMPANY | $503 | — | $503 | 14.38% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 2010 MAIN STREET, SUITE 700 IRVINE, CA 92614 | UNUM INSURANCE COMPANY | $261 | — | $261 | 13.79% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | TWO PIERCE PLACE, 21ST FL ITASCA, IL 60143 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 13.51% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTISMONROE INS SVS | 2010 MAIN STREET, SUITE 700 IRVINE, CA 92623 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | -$2 | — | -$2 | -5.41% |
| SYNERGY ENROLLMENT AND BENEFITS LLC3 Filed as: SYNERGY ENROLLMENT AND BENEFITS | 9370 SKY PARK CT STE 250 SAN DIEGO, CA 92123 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | -$4 | — | -$4 | -10.81% |
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 | 429 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 429 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA PHYSICIANS SERVICE | 281 | $4.3M |
| Dental | CALIFORNIA PHYSICIANS SERVICE | 281 | $4.3M |
| Vision | VISION SERVICE PLAN | 259 | $33K |
| Life insurance(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 429 | $268K |
| Short-term disability(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 429 | $221K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 429 | $216K |
| Prescription drug | CALIFORNIA PHYSICIANS SERVICE | 281 | $4.3M |
| Other(6 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 429 | $282K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 429 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.