| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PROGRESSIVE BENEFIT GROUP3 | 9035 SOQUEL AVE STE 200 SANTA CRUZ, CA 95062 | KAISER FOUNDATION HEALTH PLAN INC | $87K | $0 | $87K | 2.39% |
| ACRISURE LLC3 | 9035 SOQUEL AVE STE 200 SANTA CRUZ, CA 95062 | METROPOLITAN LIFE INSURANCE COMPANY | $15K | $0 | $15K | 5.37% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DR URBANDALE, IA 50323 | METROPOLITAN LIFE INSURANCE COMPANY | $14K | $0 | $14K | 4.99% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNER WEST COAST INS | 3155 OLSEN DR SAN JOSE, CA 95117 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | $2K | $7K | 2.65% |
| ACRISURE LLC3 Filed as: ACRISURE OF CA LLC | 1615 MURRAY CANYON RD STE 1050 SAN DIEGO, CA 92108 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $3K | $3K | 0.94% |
| PBG PROFESSIONAL INSURANCE SERVICES3 Filed as: PBG PROFESSIONAL INS | 9035 SOQUEL AVE STE 200 SANTA CRUZ, CA 95062 | SUTTER HEALTH PLAN | $11K | $0 | $11K | 5.00% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DR URBANDALE, IA 50323 | SAFEGAURD HEALTH PLANS, INC A CALIFORNIA CORPORATION | $387 | $0 | $387 | 5.09% |
| ACRISURE LLC3 Filed as: ACRISURE OF CA LLC | 9035 SOQUEL AVE STE 200 SANTA CRUZ, CA 95062 | SAFEGAURD HEALTH PLANS, INC A CALIFORNIA CORPORATION | $353 | $0 | $353 | 4.64% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST INS | 3155 OLSEN DR SAN JOSE, CA 95117 | SAFEGAURD HEALTH PLANS, INC A CALIFORNIA CORPORATION | $111 | $70 | $181 | 2.38% |
| ACRISURE LLC3 Filed as: ACRISURE OF CA LLC | 1615 MURRAY CANYON RD STE 1050 SAN DIEGO, CA 92108 | SAFEGAURD HEALTH PLANS, INC A CALIFORNIA CORPORATION | $0 | $80 | $80 | 1.05% |
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 | 426 | 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) | 426 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 348 | $3.9M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 426 | $279K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 426 | $271K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 426 | $271K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 426 | $271K |
| Prescription drug | SUTTER HEALTH PLAN | 26 | $216K |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 426 | $280K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 426 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.