| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INTERNATIONAL PROINSURANCE SVCS LLC3 Filed as: INTERNATIONAL PROINSURANCE SVCS | 3905 BOHANNON DRIVE #B MENLO PARK, CA 94025 | BLUE CROSS OF CALIFORNIA | $155K | $18K | $173K | 2.33% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 5664 PRAIRIE CREEK DR CALEDONIA, MI 49316 | BLUE CROSS OF CALIFORNIA | $87K | — | $87K | 1.18% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 5664 PRAIRIE CREEK DR CALEDONIA, MI 49316 | KAISER FOUNDATION HEALTH PLAN INC | $110K | — | $110K | 2.98% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INS SVCS OF CA | 2055 GATEWAY PLACE, SUITE 450 SAN JOSE, CA 95110 | KAISER FOUNDATION HEALTH PLAN INC | -$43 | — | -$43 | -0.00% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3925 BOHANNAN DRIVE, STE 100 MENLO PARK, CA 94025 | METROPOLITAN LIFE INSURANCE COMPANY | $46K | $215 | $46K | 3.87% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3925 BOHANNAN DRIVE, STE 100 MENLO PARK, CA 94025 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $7K | — | $7K | 3.00% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3925 BOHANNAN DRIVE, STE 100 MENLO PARK, CA 94025 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | — | $4K | 3.00% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3925 BOHANNAN DRIVE, STE 100 MENLO PARK, CA 94025 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $968 | — | $968 | 3.00% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3925 BOHANNAN DRIVE, STE 100 MENLO PARK, CT 94025 | SAFEGUARD HEALTH PLANS, INC. | $2K | $4 | $2K | 8.17% |
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 | 1,075 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 20 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,095 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 701 | $11.1M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 2,112 | $1.2M |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 2,112 | $1.2M |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 961 | $218K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 961 | $32K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 961 | $146K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 701 | $11.1M |
| Other | RELIANCE STANDARD LIFE INSURANCE COMPANY | 961 | $218K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,112 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.