| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 5664 PRAIRIE CREEK DR SE CALEDONIA, MI 49316 | KAISER FOUNDATION HEALTH PLAN INC | $36K | — | $36K | 4.35% |
| PROCO INSURANCE SERVICES3 | PO BOX 2540 MENLO PARK, CA 94026 | SUTTER HEALTH PLAN | $27K | — | $27K | 4.00% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 5664 PRAIRIE CREEK DRIVE SE CALEDONIA, MI 49316 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $11K | $1K | $12K | 49.34% |
| ENROLLMENT ALLIANCE LLC3 Filed as: ENROLLMENT ALLIANCE | 3030 N ROCKY POINT DR SUITE 150 TAMPA, FL 33607 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $763 | — | $763 | 3.11% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3925 BOHANNON DR STE 100 MENLO PARK, CA 94025 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $906 | $4K | 18.86% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3925 BOHANNON DR STE 100 MENLO PARK, CA 94025 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $956 | $3K | 14.17% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | DBA PROCO INSURANCE 910 E HAMILTON AVE, SUITE 410 CAMPBELL, CA 95008 | EYEMED | $1K | — | $1K | 7.39% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | DBA PROCO INSURANCE 3925 BOHANNON DRIVE, SUITE 100 MENLO PARK, CA 94025 | EYEMED | $231 | — | $231 | 1.33% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3925 BOHANNON DR STE 100 MENLO PARK, CA 94025 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $336 | $224 | $560 | 8.34% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3925 BOHANNON DR, STE 100 MENLO PARK, CA 94025 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $508 | — | $508 | 10.01% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3925 BOHANNON DR STE 100 MENLO PARK, CA 94025 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $277 | — | $277 | 10.00% |
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 | 372 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 372 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 96 | $1.5M |
| Dental | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 170 | $25K |
| Vision | EYEMED | 200 | $17K |
| Life insurance(3 contracts, 2 carriers) | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 372 | $71K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 14 | $7K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 96 | $1.5M |
| Other(5 contracts, 2 carriers) | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 372 | $79K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 372 | — |
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.