| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 2055 WOODSIDE RD, STE 290 REDWOOD CITY, CA 94061 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $153K | — | $153K | 3.30% |
| INTERNATIONAL PROINSURANCE SERVICES3 Filed as: INTERNATIONAL PROINSURANCE SERV LLC | 3925 BOHANNON DR STE 100 MENLO PARK, CA 94025 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $14K | $686 | $15K | 0.32% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 5664 PRAIRIE CREEK DR SE CALEDONIA, MI 49316 | KAISER FOUNDATION HEALTH PLAN INC | $17K | — | $17K | 3.18% |
| LEE SCHEUER3 | 3925 BOHANNON DR STE 100 MENLO PARK, CA 94025 | KAISER FOUNDATION HEALTH PLAN OF COLORADO | $5K | — | $5K | 3.66% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3925 BOHANNON DR STE 100 MENLO PARK, CA 94025 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | $4K | $11K | 8.38% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3925 BOHANNON DR STE 100 MENLO PARK, CA 94025 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $2K | $5K | 8.26% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3925 BOHANNON DR STE 100 MENLO PARK, CA 94025 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $2K | $4K | 8.30% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC DBA | PROCO INS SVCE 3925 BOHANNON DR STE 100 MENLO PARK, CA 94025 | VISION SERVICE PLAN | $2K | — | $2K | 3.89% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3925 BOHANNON DR STE 100 MENLO PARK, CA 94025 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | $757 | $2K | 8.33% |
| RHONA S UNSELL INC4 | 6525 GUNPARK DRIVE STE 370-152 BOULDER, CO 80301 | PRE-PAID SERVICE INC DBA LEGALSHIELD | $2K | — | $2K | 27.38% |
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 | 400 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 400 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 291 | $5.3M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 291 | $4.7M |
| Vision | VISION SERVICE PLAN | 297 | $45K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 400 | $126K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 400 | $53K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 400 | $64K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 102 | $674K |
| Other(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 400 | $29K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 400 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.