| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INTERNATIONAL PROINSURANCE SERVICES3 | 3925 BOHANNON DRIVE SUITE 100 MENLO PARK, CA 94025 | METROPOLITAN LIFE INSURANCE COMPANY | $8K | $1K | $10K | 16.92% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3925 BOHANNON DR SUITE 100 SAN FRANCISCO, CA 94111 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $46 | $4K | 6.45% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC DBA | AHERN INSURANCE BROKERAGE 9655 GRANITE RIDGE DR STE 500 ITASCA, IL 60142 | METROPOLITAN LIFE INSURANCE COMPANY | — | $519 | $519 | 0.92% |
| INTERNATIONAL PROINSURANCE SERVICES3 | 3925 BOHANNON DRIVE STE 100 MENLO PARK, CA 94025 | HYATT LEGAL PLANS | $2K | $559 | $2K | 6.73% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | DBA PROCO INSURANCE SERVICES 3925 BOHANNON DR., STE 100 MENLO PARK, CA 94025 | HYATT LEGAL PLANS | $2K | $84 | $2K | 5.00% |
| LBL INSURANCE SERVICES INC3 Filed as: LBL INSURANCE SERVICES, INC. | 3631 S. HARBOR BLVD STE 200 SANTA ANA, CA 92704 | HYATT LEGAL PLANS | $245 | — | $245 | 0.71% |
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 | 688 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 688 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 11 | $46K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 688 | $387K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 657 | $192K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 11 | $46K |
| Other(4 contracts, 4 carriers) | MORNEAU SHEPELL LTD | 1,397 | $237K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,397 | — |
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.