| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 1615 MURRAY CANYON RD STE 1050 SAN DIEGO, CA 92108 | CALIFORNIACHOICE | $17K | — | $17K | 4.90% |
| AMWINS3 Filed as: AMWINS CONNECT INS SVCS LLC | — | CALIFORNIACHOICE | $10K | — | $10K | 2.95% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA DBA AHERN | INSURANCE BROKERAGE 5664 PRAIRIE CREEK DR SE CALEDONIA, MI 49316 | KAISER HEALTH PLAN OF COLORADO | $1K | — | $1K | 4.01% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 1615 MURRAY CANYON RD STE 1050 SAN DIEGO, CA 92108 | CHOICEBUILDER | $1K | — | $1K | 9.99% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFIT GROUP | — | CHOICEBUILDER | $495 | — | $495 | 3.93% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA | DBA AHERN-ELT INSURANCE SERVICES 1615 MURRAY CANYON RD, STE 1050 SAN DIEGO, CA 92108 | PRINCIPAL LIFE INSURANCE COMPANY | $726 | — | $726 | 9.15% |
| GA SOLUTIONS LLC3 | 311 CLOCK TOWER CMNS BREWSTER, NY 10509 | PRINCIPAL LIFE INSURANCE COMPANY | — | $399 | $399 | 5.03% |
| ACRISURE LLC3 | PO BOX 1788 GRAND RAPIDS, MI 49501 | PRINCIPAL LIFE INSURANCE COMPANY | — | $38 | $38 | 0.48% |
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 | 115 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 115 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIACHOICE | 42 | $384K |
| Dental(3 contracts, 3 carriers) | CALIFORNIACHOICE | 42 | $375K |
| Vision | CALIFORNIACHOICE | 42 | $356K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 165 | $8K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 165 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.