| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PBG PROFESSIONAL INSURANCE SERVICES3 | 9035 SOQUEL AVE SUITE 200 SANTA CRUZ, CA 950622033 | SUTTER HEALTH PLUS | $74K | $0 | $74K | 4.00% |
| PROGRESSIVE BENEFIT GROUP3 | 9035 SOQUEL AVE STE 200 SANTA CRUZ, CA 950622033 | KAISER PERMANENTE | $30K | $0 | $30K | 3.90% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 9035 SOQUEL AVENUE STE 200 SANTA CRUZ, CA 950622033 | DELTA DENTAL | $20K | $0 | $20K | 8.00% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 9035 SOQUEL AVE SUITE 200 SANTA CRUZ, CA 95062 | KAISER FOUNDATION HEALTH | $672 | $0 | $672 | 1.25% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC DB | 9035 SOQUEL AVE SANTA CRUZ, CA 950622033 | VISION SERVICE PLAN | $1K | $0 | $1K | 3.60% |
| JAMES W. MOORADIAN3 Filed as: JAMES W MOORADIAN | 6 HIGHLAND ROAD CHARLESTOWN, RI 02116 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $1K | $4K | 14.75% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 9035 SOQUEL AVENUE STREET 200 SANTA CRUZ, CA 95062 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $673 | $0 | $673 | 2.60% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 9035 SOQUEL AVENUE STREET 200 SANTA CRUZ, CA 950622033 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $149 | $0 | $149 | 0.58% |
| PROGRESSIVE BENEFIT GROUP3 | 9035 SOQUEL AVE SUITE 200 SANTA CRUZ, CA 950622033 | MUTUAL OF OMAHA | $4K | $0 | $4K | 14.99% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DR URBANDALE, IA 50323 | MUTUAL OF OMAHA | $0 | $1K | $1K | 5.00% |
| PROGRESSIVE BENEFIT GROUP3 | 9035 SOQUEL AVE SUITE 200 SANTA CRUZ, CA 950622033 | MUTUAL OF OMAHA | $0 | $184 | $184 | 0.71% |
| PROGRESSIVE BENEFIT GROUP3 | 9035 SOQUEL AVE SUITE 200 SANTA CRUZ, CA 95062 | MUTUAL OF OMAHA | $3K | $0 | $3K | 14.99% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DR URBANDALE, IA 50323 | MUTUAL OF OMAHA | $0 | $1K | $1K | 5.00% |
| PROGRESSIVE BENEFIT GROUP3 | 9035 SOQUEL AVE SUITE 200 SANTA CRUZ, CA 95062 | MUTUAL OF OMAHA | $0 | $215 | $215 | 0.98% |
| PROGRESSIVE BENEFIT GROUP3 | 9035 SOQUEL AVE SUITE 200 SANTA CRUZ, CA 95062 | EMPATHIA PACIFIC, INC | $0 | $0 | $0 | 0.00% |
| PROGRESSIVE BENEFIT GROUP3 | 9035 SOQUEL AVE STE 200 SANTA CRUZ, CA 95062 | MUTUAL OF OMAHA | $626 | $0 | $626 | 14.99% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DR URBANDALE, IA 50323 | MUTUAL OF OMAHA | $0 | $209 | $209 | 5.01% |
| PROGRESSIVE BENEFIT GROUP3 | 9035 SOQUEL AVE STE 200 SANTA CRUZ, CA 95062 | MUTUAL OF OMAHA | $0 | $94 | $94 | 2.25% |
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 | 303 | 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) | 303 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 4 carriers) | SUTTER HEALTH PLUS | 303 | $2.7M |
| Dental | DELTA DENTAL | 210 | $251K |
| Vision | VISION SERVICE PLAN | 210 | $36K |
| Life insurance | MUTUAL OF OMAHA | 247 | $22K |
| Short-term disability(2 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 54 | $30K |
| Long-term disability | MUTUAL OF OMAHA | 248 | $26K |
| Prescription drug(2 contracts, 2 carriers) | SUTTER HEALTH PLUS | 303 | $2.6M |
| Other(4 contracts, 3 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 247 | $62K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 303 | — |
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.