| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | BLUE SHIELD OF CALIFORNIA | $0 | $45K | $45K | 4.17% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 9035 SOQUEL AVE STE 200 SANTA CRUZ, CA 95062 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $390 | $0 | $390 | 5.11% |
| ACRISURE LLC3 Filed as: ACRISURE PTNRS WEST COAST INS SVCS | 3155 OLSEN DRIVE STE 400 SAN JOSE, CA 95117 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $240 | $0 | $240 | 3.15% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | CONTINENTAL AMERICA INSURANCE COMPANY | $3K | $0 | $3K | 44.40% |
| BRIAN W PATTEN3 Filed as: BRIAN WILLIAM PATTEN | 121 BUCKTHORN RD BADEN, PA 15005 | CONTINENTAL AMERICA INSURANCE COMPANY | $2K | $0 | $2K | 39.02% |
| JONATHAN DAVID BESWARICK3 | 250 ESTATES DRIVE GIBSONIA, PA 15044 | CONTINENTAL AMERICA INSURANCE COMPANY | $372 | $0 | $372 | 5.95% |
| HEATHER M BARTLEY3 | 602 BEAVER CT WEXFORD, PA 15090 | CONTINENTAL AMERICA INSURANCE COMPANY | $334 | $0 | $334 | 5.34% |
| VICTOR NORDENFLYCHT-DARBY3 | 710 N PASS AVENUE BURBANK, CA 91505 | CONTINENTAL AMERICA INSURANCE COMPANY | $315 | $0 | $315 | 5.04% |
| MARIANNE E SULLIVAN3 Filed as: MARIANNE ELIZABETH SULLIVAN | 305 WATERFORD COURT CRANBERRY TWP, PA 16066 | CONTINENTAL AMERICA INSURANCE COMPANY | $16 | $0 | $16 | 0.26% |
| ACRISURE LLC3 Filed as: ACRISURE OF CA LLC DBA PROGRESSIVE | 611 ANTON BLVD STE 1400 COSTA MESA, CA 92626 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | $10 | $6K | — |
| BENEFITS MATCHMAKING LLC3 | 23716 BIRTCHER DR LAKE FOREST, CA 92630 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $0 | $3K | — |
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 | 117 | 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) | 117 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE SHIELD OF CALIFORNIA | 105 | $1.1M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 0 | $0 |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 0 | $0 |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 117 | $8K |
| Prescription drug | BLUE SHIELD OF CALIFORNIA | 105 | $1.1M |
| Other(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 117 | $14K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 117 | — |
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.