| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INTERNATIONAL PROINSURANCE SERVICES3 | 3925 BOHANNON DR., STE. 100 MENLO PARK, CA 94025 | KAISER FOUNDATION HEALTH PLAN INC | $24K | — | $24K | 2.70% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 5664 PRAIRIE CREEK DR. SE CALEDONIA, MI 49316 | KAISER FOUNDATION HEALTH PLAN INC | $17K | — | $17K | 1.91% |
| INTERNATIONAL PROINSURANCE SERVICES3 | 3925 BOHANNON DRIVE, SUITE 100 MENLO PARK, CA 94025 | ANTHEM BLUE CROSS | $13K | — | $13K | 1.74% |
| INTERNATIONAL PROINSURANCE SERVICES3 | PO BOX 2540 MENLO PARK, CA 94026 | UNION SECURITY INSURANCE COMPANY | $9K | — | $9K | 7.01% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3925 BOHANNON DR., STE. 100 MENLO PARK, CA 94025 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 8.65% |
| INTERNATIONAL PROINSURANCE SERVICES3 | 3925 BOHANNON DR., STE. 100 MENLO PARK, CA 94025 | VISION SERVICE PLAN | $895 | — | $895 | 3.63% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC DBA | PROCO INS SVCE 3925 BOHANNON DR., STE. 100 MENLO PARK, CA 94025 | VISION SERVICE PLAN | $351 | — | $351 | 1.42% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3925 BOHANNON DR., STE. 100 MENLO PARK, CA 94025 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 13.09% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3925 BOHANNON DR. STE. 100 MENLO PARK, CA 94025 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $379 | — | $379 | 11.99% |
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 | 138 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 138 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 104 | $1.7M |
| Dental | UNION SECURITY INSURANCE COMPANY | 111 | $127K |
| Vision | VISION SERVICE PLAN | 115 | $25K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 151 | $27K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 151 | $24K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 104 | $1.7M |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 151 | $3K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 151 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.