| 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 | ROCKY MOUNTAIN HOSPITAL & MEDICAL SERVICE, INC. | $41K | — | $41K | 4.79% |
| ACRISURE LLC3 Filed as: ACRISURE SOUTHWEST PARTNERS INSURAN | 4000 WESTERLY PLACE SUITE 110 NEWPORT BEACH, CA 92660 | ROCKY MOUNTAIN HOSPITAL & MEDICAL SERVICE, INC. | $29K | — | $29K | 3.48% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3 POLARIS WAY 4TH FLOOR ALISO VIEJO, CA 92656 | GUARDIAN | $32K | — | $32K | 13.30% |
| ACRISURE LLC3 Filed as: ACRISURE SOUTHWEST PARTNERS INSURAN | 4000 WESTERLY PLACE SUITE 110 NEWPORT BEACH, CA 92660 | GUARDIAN | — | $22K | $22K | 9.34% |
| ACRISURE LLC3 Filed as: ACRISURE SOUTHWEST PARTNERS INSURAN | 611 ANTON BOULEVARD COSTA MESA, CA 92626 | TRANSAMERICA LIFE INSURANCE COMPANY | $20K | — | $20K | 22.56% |
| WEBTPA EMPLOYER SERVICES LLC5 Filed as: WEBTPA | 8500 FREEPORT PKWY SOUTH IRVING, TX 75063 | TRANSAMERICA LIFE INSURANCE COMPANY | — | $10K | $10K | 11.60% |
| PARAGON PARTNERS LTD3 Filed as: PARAGON PARTNERS LIMITED | 9420 EAST DOUBLETREE RANCH ROAD SCOTTSDALE, AZ 85258 | TRANSAMERICA LIFE INSURANCE COMPANY | $9K | — | $9K | 10.53% |
| AMWINS5 Filed as: AMWINS GROUP BENEFITS, LLC | 50 WHITECAP DRIVE NORTH KINGSTOWN, RI 02852 | TRANSAMERICA LIFE INSURANCE COMPANY | — | $5K | $5K | 5.69% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 100 OTTAWA AVENUE SW GRAND RAPIDS, MI 49503 | CONTINENTAL AMERICAN INSURANCE COMPANY | $25K | — | $25K | 33.91% |
| ENROLLMENT BENEFIT CONCEPTS LLC3 Filed as: ENROLLMENT BENEFIT CONCEPTS, LLC | 100 OTTAWA AVENUE SW GRAND RAPIDS, MI 49503 | CONTINENTAL AMERICAN INSURANCE COMPANY | $19K | — | $19K | 25.07% |
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 | 242 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 243 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | ROCKY MOUNTAIN HOSPITAL & MEDICAL SERVICE, INC. | 146 | $1.4M |
| Dental(2 contracts, 2 carriers) | ROCKY MOUNTAIN HOSPITAL & MEDICAL SERVICE, INC. | 242 | $1.1M |
| Vision(2 contracts, 2 carriers) | ROCKY MOUNTAIN HOSPITAL & MEDICAL SERVICE, INC. | 242 | $1.1M |
| Life insurance | GUARDIAN | 242 | $239K |
| Short-term disability | GUARDIAN | 242 | $239K |
| Long-term disability | GUARDIAN | 242 | $239K |
| Other(3 contracts, 3 carriers) | GUARDIAN | 242 | $402K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 242 | — |
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.