| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $64K | $12K | $76K | 4.46% |
| ACRISURE LLC3 Filed as: ACRISURE PGM INSURANCESERVICES LLC | 311 CLOCK TOWER COMMONS BREWSTER, NY 10509 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | — | $28K | $28K | 1.64% |
| RELATIONAL ADVISORS, LLC3 | 5151 CALIFORNIA AVE., STE. 100 IRVINE, CA 92617 | CALIFORNIA PHYSICIANS' SERVICE | $6K | — | $6K | 3.57% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INS SVC | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 91361 | CALIFORNIA PHYSICIANS' SERVICE | — | $4K | $4K | 2.25% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3 POLARIS WAY 4TH FLOOR ALISO VIEJO, CA 92656 | CALIFORNIA PHYSICIANS' SERVICE | — | $2K | $2K | 1.43% |
| ACRISURE LLC3 | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | ANTHEM LIFE & DISABILITY INSURANCE COMPANY | $10K | — | $10K | 13.60% |
| ACRISURE LLC3 Filed as: ACRISURE PGM INSURANCESERVICES LLC | 311 CLOCK TOWER COMMONS BREWSTER, NY 10509 | ANTHEM LIFE & DISABILITY INSURANCE COMPANY | — | $3K | $3K | 4.53% |
| RELATIONAL ADVISORS, LLC3 | DBA RELATIONAL ADVISORS 5151 CALIFORNIA AVE STE 100 IRVINE, CA 92617 | PRINCIPAL LIFE INSURANCE COMPANY | $4K | $1K | $5K | 11.71% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SVCS INC | ATTN ACCOUNTING DEPT. 32110 AGOURA RD WESTLAKE VLG, CA 91361 | PRINCIPAL LIFE INSURANCE COMPANY | $3K | — | $3K | 5.95% |
| ACRISURE LLC3 Filed as: ACRISURE LLC DBA HNI RISK SERVICES | 16805 W CLEVELAND AVE NEW BERLIN, WI 53151 | PRINCIPAL LIFE INSURANCE COMPANY | $1K | — | $1K | 2.52% |
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 | 735 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 735 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 449 | $1.9M |
| Dental(2 contracts, 2 carriers) | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 449 | $1.7M |
| Vision(3 contracts, 3 carriers) | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 449 | $1.9M |
| Life insurance(2 contracts, 2 carriers) | ANTHEM LIFE & DISABILITY INSURANCE COMPANY | 68 | $117K |
| Short-term disability | ANTHEM LIFE & DISABILITY INSURANCE COMPANY | 59 | $74K |
| Prescription drug | CALIFORNIA PHYSICIANS' SERVICE | 68 | $162K |
| Other | PRINCIPAL LIFE INSURANCE COMPANY | 68 | $43K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 449 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.