| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | BLUE CROSS OF CALIFORNIA | $272K | — | $272K | 3.15% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 5664 PRAIRIE CREEK DR SE CALEDONIA, MI 49316 | KAISER FOUNDATION HEALTH PLAN INC | $24K | — | $24K | 3.20% |
| LEE SCHEUER3 | 3925 BOHANNON DR STE 100 MENLO PARK, CA 94025 | KAISER FOUNDATION HEALTH PLAN OF COLORADO | $5K | — | $5K | 4.27% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 2055 WOODSIDE RD STE 290 REDWOOD CITY, CA 94061 | VISION SERVICE PLAN | $2K | — | $2K | 2.86% |
| RHONA S UNSELL INC4 | 6525 GUNPARK DRIVE STE 370-152 BOULDER, CO 80301 | PRE-PAID SERVICE INC DBA LEGALSHIELD | $4K | — | $4K | 18.38% |
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 | 554 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 10 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 564 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 428 | $9.5M |
| Vision | VISION SERVICE PLAN | 430 | $81K |
| Life insurance | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 554 | $444K |
| Short-term disability | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 554 | $444K |
| Long-term disability | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 554 | $444K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 104 | $860K |
| Other(3 contracts, 3 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 554 | $530K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 554 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.