| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PBG PROFESSIONAL INSURANCE SERVICES3 | 9035 SOQUEL AVE STE 200 SANTA CRUZ, CA 95062 | SUTTER HEALTH PLAN | $85K | $0 | $85K | 4.00% |
| PROGRESSIVE BENEFIT GROUP3 | 9035 SOQUEL AVE SUITE 200 SANTA CRUZ, CA 95062 | KAISER FOUNDATION HEALTH PLAN INC | $29K | $0 | $29K | 4.35% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST INSURA | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | KAISER FOUNDATION HEALTH PLAN INC | $0 | $1 | $1 | 0.00% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 9035 SOQUEL AVE SUITE 200 SANTA CRUZ, CA 95062 | DELTA DENTAL | $15K | $0 | $15K | 6.04% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | DELTA DENTAL | $5K | $0 | $5K | 1.96% |
| PROGRESSIVE BENEFIT GROUP3 | 9035 SOQUEL AVE SUITE 200 SANTA CRUZ, CA 95062 | KAISER FOUNDATION HEALTH PLAN INC | $4K | $0 | $4K | 3.95% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC DBA PBG | 9035 SOQUEL AVE STE 200 SANTA CRUZ, CA 95062 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $3K | $0 | $3K | 4.53% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST INSURA | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | VISION SERVICE PLAN | $1K | $0 | $1K | 4.01% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC DBA PBG | 9035 SOQUEL AVENUE STE 200 SANTA CRUZ, CA 950622033 | VISION SERVICE PLAN | $607 | $0 | $607 | 1.65% |
| PROGRESSIVE BENEFIT GROUP3 | 9035 SOQUEL AVE SUITE 200 SANTA CRUZ, CA 95062 | UNITED OF OMAHA LIFE INSUARNCE COMPANY | $3K | $636 | $4K | 17.96% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DR URBANDALE, IA 50323 | UNITED OF OMAHA LIFE INSUARNCE COMPANY | $0 | $1K | $1K | 5.00% |
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 | 293 | 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) | 293 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | SUTTER HEALTH PLAN | 293 | $2.1M |
| Dental | DELTA DENTAL | 208 | $252K |
| Vision | VISION SERVICE PLAN | 202 | $37K |
| Life insurance | UNITED OF OMAHA LIFE INSUARNCE COMPANY | 237 | $22K |
| Prescription drug | SUTTER HEALTH PLAN | 293 | $2.1M |
| Other(7 contracts, 6 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 254 | $917K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 293 | — |
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.