| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC DBA | IBP INSURANCE SERVICES 175 BERNAL RD., SUITE 100 SAN JOSE, CA 95119 | AETNA LIFE INSURANCE CO. | $134K | — | $134K | 4.98% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | DBA IBP INS SERV 175 BERNAL RD, SUITE 100 SAN JOSE, CA 95119 | AETNA HEALTH, INC. | $11K | — | $11K | 4.95% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 910 E HAMILTON AVE, 410 CAMPBELL, CA 95008 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $7K | — | $7K | 9.97% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 100 OTTAWA AVE, SW GRAND RAPIDS, MI 49503 | SUN LIFE ASSURANCE COMPANY OF CANADA | $4K | — | $4K | 10.03% |
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 | 263 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 263 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA LIFE INSURANCE CO. | 321 | $2.9M |
| Dental | AETNA LIFE INSURANCE CO. | 321 | $2.7M |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 340 | $72K |
| Life insurance | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 340 | $72K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 108 | $40K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 340 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.