| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PROGRESSIVE BENEFIT GROUP3 | 9035 SOQUEL AVE SUITE 200 SANTA CRUZ, CA 95062 | BLUE SHIELD OF CALIFORNIA | $10K | $89K | $100K | 4.10% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 5664 PRAIRIE CREEK DRIVE. SE CALEDONIA, MI 49316 | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | $20K | $0 | $20K | 10.09% |
| PROGRESSIVE BENEFIT GROUP3 | 9035 SOQUEL AVE SUITE 200 SANTA CRUZ, CA 95062 | KAISER FOUNDATION HEALTH PLAN INC | $6K | $0 | $6K | 3.61% |
| PROGRESSIVE BENEFIT GROUP3 | 9035 SOQUEL AVE STE 200 SANTA CRUZ, CA 95062 | UNITED OF OMAHA LIFE INSUARNCE COMPANY | $4K | $107 | $4K | 10.30% |
| PROGRESSIVE BENEFIT GROUP3 | 9035 SOQUEL AVE STE 200 SANTA CRUZ, CA 95062 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $2K | $0 | $2K | 6.34% |
| PROGRESSIVE BENEFIT GROUP3 | 9035 SOQUEL AVE SUITE 200 SANTA CRUZ, CA 95062 | KAISER FOUNDATION HEALTH PLAN INC | $1K | $0 | $1K | 3.63% |
| PROGRESSIVE BENEFIT GROUP3 | 9035 SOQUEL AVE STE 200 SANTA CRUZ, CA 95062 | UNITED OF OMAHA LIFE INSUARNCE COMPANY | $3K | $83 | $3K | 10.29% |
| CHRISTINE PETROCELLI3 | 9035 SOQUEL AVE STE 200 SANTA CRUZ, CA 95062 | SUN LIFE ASSURANCE COMPANY | $3K | $0 | $3K | 16.14% |
| PROGRESSIVE BENEFIT GROUP3 | 9035 SOQUEL AVE STE 200 SANTA CRUZ, CA 95062 | GUARDIAN | $716 | $0 | $716 | 20.01% |
| PACIFIC ADVISORS LLC3 | 333 INDIAN HILL BLVD CLAREMONT, CA 91711 | GUARDIAN | $54 | $0 | $54 | 1.51% |
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 | 210 | 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) | 210 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | BLUE SHIELD OF CALIFORNIA | 324 | $2.6M |
| Dental | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 190 | $197K |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 173 | $35K |
| Life insurance(3 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSUARNCE COMPANY | 210 | $92K |
| Long-term disability(2 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 210 | $63K |
| Prescription drug | BLUE SHIELD OF CALIFORNIA | 324 | $2.4M |
| Other(3 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSUARNCE COMPANY | 210 | $61K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 324 | — |
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.