| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST INS SE | 1950 W CORPORATE WAY # 33276 ANAHEIM, CA 92801 | UNITEDHEALTHCARE INSURANCE COMPANY | $40K | — | $40K | 3.45% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | UNITEDHEALTHCARE INSURANCE COMPANY | $4K | — | $4K | 0.35% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST INS SE | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 95008 | UNITEDHEALTHCARE INSURANCE COMPANY | $685 | — | $685 | 9.18% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | DBA PROCO INS SVCS P.O. BOX 1788 GRAND RAPIDS, MI 49501 | UNITEDHEALTHCARE INSURANCE COMPANY | $61 | — | $61 | 0.82% |
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 | 168 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 168 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 244 | $1.1M |
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 244 | $1.1M |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 244 | $1.1M |
| Life insurance | UNITEDHEALTHCARE INSURANCE COMPANY | 165 | $7K |
| Other | UNITEDHEALTHCARE INSURANCE COMPANY | 165 | $7K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 244 | — |
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.