| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST | INSURANCE SERVICES LLC 900 E HAMILTON AVE, SUITE 500 CAMPBELL, CA 95008 | BLUE CROSS OF CALIFORNIA | $60K | — | $60K | 5.39% |
| ACRISURE LLC3 | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | BLUE CROSS OF CALIFORNIA | — | $1K | $1K | 0.11% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST INS | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | KAISER FOUNDATION HEALTH PLAN INC | $12K | — | $12K | 3.69% |
| FILICE INSURANCE AGENCY3 | 900 E HAMILTON AVE, STE 500 CAMPBELL, CA 95008 | KAISER FOUNDATION HEALTH PLAN INC | $4K | — | $4K | 1.31% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST INS | 900 EAST HAMILTON AVE SUITE 500 CAMPBELL, CA 95008 | DELTA DENTAL OF CALIFORNIA | $10K | — | $10K | 9.99% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 E HAMILTON AVE, STE 500 CAMPBELL, CA 95008 | DELTA DENTAL OF CALIFORNIA | $3K | — | $3K | 2.99% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST INS | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | KAISER FOUNDATION HEALTH PLAN INC | $2K | — | $2K | 3.78% |
| FILICE INSURANCE AGENCY3 | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 95008 | KAISER FOUNDATION HEALTH PLAN INC | $607 | — | $607 | 1.22% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST INS | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $900 | $4K | 11.49% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST | INSURANCE SERVICES LLC 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | VISION SERVICE PLAN | $1K | — | $1K | 10.00% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST INS | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $406 | $115 | $521 | 11.88% |
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 | 144 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 147 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 57 | $1.5M |
| Dental | DELTA DENTAL OF CALIFORNIA | 204 | $101K |
| Vision | VISION SERVICE PLAN | 87 | $13K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 146 | $43K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 146 | $4K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 204 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.