| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 | PO BOX 1788 GRAND RAPIDS, MI 49501 | UNITEDHEALTHCARE INSURANCE COMPANY | $33K | $0 | $33K | 5.05% |
| ACRISURE LLC3 | 2033 GATEWAY PLACE, SUITE 150 SAN JOSE, CA 95110 | KAISER FOUNDATION HEALTH PLAN INC | $11K | $0 | $11K | 4.16% |
| ACRISURE LLC3 | UNKNOWN GRAND RAPIDS, MI 49501 | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | $15K | $0 | $15K | 18.41% |
| INTERWEST INSURANCE SERVICES, LLC3 Filed as: INTERWEST INSURANCE SERVICES LLC | UNKNOWN SACRAMENTO, CA 95826 | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | $644 | $0 | $644 | 0.80% |
| PROFESSIONAL GROUP PLANS INC3 | UNKNOWN HAUPPAUGE, NY 11788 | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | $0 | $322 | $322 | 0.40% |
| ACRISURE LLC3 | 2033 GATEWAY PLACE, SUITE 150 SAN JOSE, CA 95110 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $375 | $5K | 16.63% |
| INTERWEST INSURANCE SERVICES, LLC3 Filed as: INTERWEST INSURANCE SERVICES LLC | 8950 CAL CENTER DRIVE BUILDING 3, SUITE 200 SACRAMENTO, CA 95826 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $456 | $0 | $456 | 1.40% |
| ACRISURE LLC3 | 2033 GATEWAY PLACE, SUITE 150 SAN JOSE, CA 95110 | AFLAC | $2K | $0 | $2K | 7.75% |
| WILLIAM K VERBRUGGE3 Filed as: WILLIAM VERBRUGGE AND OTHER AGENTS | 27 CRYSTAL SPRINGS ROAD, UNIT 6 SAN MATEO, CA 94402 | AFLAC | $687 | $19 | $706 | 3.39% |
| DANNY LEON3 | 10550 BAYMEADOWS ROAD, UNIT 429 JACKSONVILLE, FL 32256 | AFLAC | $374 | $231 | $605 | 2.91% |
| GIBRAN AHMAD CHAUDHRY3 Filed as: GIBRAN CHAUDHRY | 90 GREAT OAKS BOULEVARD, SUITE 103 SAN JOSE, CA 95119 | AFLAC | $435 | $4 | $439 | 2.11% |
| NICHOLAS J PISANO JR3 Filed as: NICHOLAS PISANO | 15781 CANON DRIVE LOS GATOS, CA 95030 | AFLAC | $183 | $0 | $183 | 0.88% |
| FALCE BENEFITS GROUP INC.3 Filed as: FALCE BENEFITS GROUP INC | 191 CYPRESS LANE WATSONVILLE, CA 95076 | AFLAC | $165 | $4 | $169 | 0.81% |
| JAYSON C ROCHA3 Filed as: JAYSON ROCHA | 3279 SOUTHERLAND ROAD WEST SACRAMENTO, CA 95691 | AFLAC | $101 | $0 | $101 | 0.49% |
| ACRISURE LLC3 | 2033 GATEWAY PLACE, SUITE 150 SAN JOSE, CA 95110 | CALIFORNIA DENTAL NETWORK, INC | $385 | $0 | $385 | 12.22% |
| INTERWEST INSURANCE SERVICES, LLC3 Filed as: INTERWEST INSURANCE SERVICES LLC | 1357 EAST LASSEN AVENUE CHICO, CA 95973 | CALIFORNIA DENTAL NETWORK, INC | $30 | $0 | $30 | 0.95% |
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 | 115 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 115 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 61 | $908K |
| Dental(2 contracts, 2 carriers) | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 82 | $84K |
| Vision | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 82 | $81K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 115 | $33K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 115 | $33K |
| Prescription drug(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 61 | $908K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 115 | $53K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 115 | — |
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.