| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 5664 PRAIRIE CREEK DRIVE SE CALEDONIA, MI 49316 | KAISER FOUNDATION HEALTH PLAN INC | $37K | $0 | $37K | 3.89% |
| PROCO INSURANCE SERVICES3 | PO BOX 2540 MENLO PARK, CA 94026 | SUTTER HEALTH PLAN | $16K | $0 | $16K | 2.32% |
| PROCO INSURANCE SERVICES3 Filed as: PROCO INSURANCE SERVICES - CAMPBELL | 910 EAST HAMILTON AVENUE, SUITE 410 CAMPBELL, CA 95008 | SUTTER HEALTH PLAN | $11K | $0 | $11K | 1.68% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 9140 EAST HAMILTON AVENUE SUITE 410 CAMPBELL, CA 95008 | UNITED OF OMAHA INSURANCE COMPANY | $8K | $0 | $8K | 11.16% |
| ENROLLMENT ALLIANCE LLC5 Filed as: ENROLLMENT ALLIANCE, LLC | 1724 EAST 5TH AVENUE TAMPA, FL 33605 | UNITED OF OMAHA INSURANCE COMPANY | $0 | $5K | $5K | 6.39% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 3925 BOHANNON DRIVE, SUITE 100 MENLO PARK, CA 94025 | UNITED OF OMAHA INSURANCE COMPANY | $0 | $4K | $4K | 5.83% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 910 EAST HAMILTON AVENUE, SUITE 410 CAMPBELL, CA 95008 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $1K | $0 | $1K | 8.51% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 3 POLARIS WAY, 4TH FLOOR ALISO VIEJO, CA 92656 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $1K | $1K | $3K | 37.50% |
| ENROLLMENT ALLIANCE LLC3 Filed as: ENROLLMENT ALLIANCE | 3030 NORTH ROCKY POINT DRIVE SUITE 150 TAMPA, FL 33607 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $378 | $0 | $378 | 5.40% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 2055 WOODSIDE ROAD, SUITE 290 REDWOOD CITY, CA 94061 | METLIFE LEGAL PLANS | $491 | $0 | $491 | 9.99% |
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 | 314 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 315 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 105 | $1.6M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 180 | $7K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 196 | $13K |
| Life insurance | UNITED OF OMAHA INSURANCE COMPANY | 365 | $72K |
| Long-term disability | UNITED OF OMAHA INSURANCE COMPANY | 365 | $72K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 105 | $1.6M |
| Other(4 contracts, 4 carriers) | UNITED OF OMAHA INSURANCE COMPANY | 365 | $89K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 365 | — |
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."
No prospect flags tripped on this filing.