| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 5664 PRAIRIE CREEK DR S CALEDONIA, MI 49316 | KAISER FOUNDATION HEALTH PLAN INC | $84K | — | $84K | 4.96% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 5664 PRAIRIE CREEK DR SE CALEDONIA, MI 49316 | KAISER FOUNDATION HEALTH PLAN INC | $40K | — | $40K | 5.12% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST | 3155 OLSEN DRIVE STE 400 SAN JOSE, CA 95117 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | $953 | $8K | 17.00% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 910 E HAMILTON AVE STE 410 CAMPBELL, CA 95008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $853 | $4K | 9.23% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 910 E HAMILTON AVE STE 410 CAMPBELL, CA 95008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $798 | $7K | 17.00% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3155 OLSEN DR STE 400 SAN JOSE, CA 95117 | VISION SERVICE PLAN | $2K | — | $2K | 4.36% |
| REMMEL SOLUTIONS4 | 1183 SWALLOWTAIL WAY NIPOMO, CA 93444 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $1K | — | $1K | 9.60% |
| ACRISURE LLC4 Filed as: ACRISURE OF CALIFORNIA LLC | 5300 STEVENS CREEK BLVD FL 3 SAN JOSE, CA 95159 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $814 | — | $814 | 7.05% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA | 910 E HAMILTON AVE STE 410 CAMPBELL, CA 95008 | DELTA DENTAL OF CALIFORNIA | $36 | — | $36 | 0.36% |
| SYNERGY ENROLLMENT AND BENEFITS LLC3 Filed as: SYNERGY ENROLLMENT AND BENEFITS, LL | 9370 SKY PARK CT SUITE 250 SAN DIEGO, CA 92123 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $135 | $3 | $138 | 6.31% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | PO BOX 1788 GRAND RAPIDS, MI 49501 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $53 | $1 | $54 | 2.47% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, | LLC DBA PROCO INSURANCE SE 910 E HAMILTON AVE, STE 410 CAMPBELL, CA 95008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5 | — | $5 | 0.23% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 910 E HAMILTON AVE STE 410 CAMPBELL, CA 95008 | DELTA DENTAL OF CALIFORNIA | $21 | — | $21 | 0.97% |
| SYNERGY ENROLLMENT AND BENEFITS LLC3 Filed as: SYNERGY ENROLLMENT AND BENEFITS, LL | 9370 SKY PARK CT SUITE 250 SAN DIEGO, CA 92123 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $68 | — | $68 | 3.49% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | DBA PROCO INSURANCE SE 910 E HAMILTON AVE, STE 410 CAMPBELL, CA 95008 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $30 | — | $30 | 1.54% |
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 | 382 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 382 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC | 218 | $2.5M |
| Dental(2 contracts) | DELTA DENTAL OF CALIFORNIA | 33 | $12K |
| Vision | VISION SERVICE PLAN | 304 | $38K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 382 | $83K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 91 | $48K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 91 | $48K |
| Other(5 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 382 | $98K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 382 | — |
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.