| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | BLUE CROSS OF CALIFORNIA | $32K | $10K | $42K | 0.70% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INS BROKERAGE INC | 160 FEDERAL STREET BOSTON, MA 01982 | BLUE CROSS OF CALIFORNIA | -$35 | — | -$35 | -0.00% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $2K | $597 | $2K | 0.70% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INS BROKERAGE INC | 160 FEDERAL STREET BOSTON, MA 01982 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | -$2 | — | -$2 | -0.00% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | METROPOLITAN LIFE INSURANCE COMPANY | $17K | $1K | $18K | 18.57% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | $1K | $6K | 6.15% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | VISION SERVICE PLAN | $2K | — | $2K | 3.93% |
| DESSO FORMAN3 | 28059 US HWY 19 N, SUITE 201 CLEARWATER, FL 33761 | METROPOLITAN LIFE INSURANCE COMPANY | $15K | — | $15K | 41.84% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | METROPOLITAN LIFE INSURANCE COMPANY | $8K | $281 | $8K | 23.58% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $591 | $2K | 6.90% |
| DESSO FORMAN3 | 28059 US HWY 19 N, SUITE 201 CLEARWATER, FL 33761 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | — | $3K | 11.66% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $184 | $2K | 6.89% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | $424 | $2K | 6.70% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS5 | PO BOX 9201 AUSTIN, TX 78766 | METROPOLITAN LIFE INSURANCE COMPANY | — | $2 | $2 | 0.01% |
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 | 824 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 827 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 534 | $6.1M |
| Dental | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 824 | $347K |
| Vision | VISION SERVICE PLAN | 515 | $44K |
| Life insurance(2 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 824 | $445K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 267 | $98K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 267 | $98K |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 534 | $6.1M |
| Other(4 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 824 | $508K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 824 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.