| 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 | $78K | $0 | $78K | 4.00% |
| PROGRESSIVE BENEFIT GROUP3 | 9035 SOQUEL AVE STE 200 SANTA CRUZ, CA 950622033 | KAISER PERMANENTE | $32K | $0 | $32K | 4.03% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 9035 SOQUEL AVENUE STE 200 SANTA CRUZ, CA 950622033 | DELTA DENTAL | $21K | $0 | $21K | 8.00% |
| PROGRESSIVE BENEFIT GROUP3 | 9035 SOQUEL AVE STE 200 SANTA CRUZ, CA 95062 | KAISER FOUNDATION HEALTH PLAN INC | $4K | $0 | $4K | 3.66% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 9035 SOQUEL AVE SUITE 200 SANTA CRUZ, CA 95062 | KAISER FOUNDATION HEALTH | $3K | $0 | $3K | 5.00% |
| JAMES W. MOORADIAN3 Filed as: JAMES W MOORADIAN | 6 HIGHLAND ROAD CHARLESTOWN, RI 02116 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $2K | $6K | 16.09% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 9035 SOQUEL AVENUE STREET 200 SANTA CRUZ, CA 95062 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $0 | $1K | 3.29% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC DB | 9035 SOQUEL AVE SANTA CRUZ, CA 950622033 | VISION SERVICE PLAN | $2K | $0 | $2K | 4.92% |
| PROGRESSIVE BENEFIT GROUP3 | 9035 SOQUEL AVE SUITE 200 SANTA CRUZ, CA 950622033 | MUTUAL OF OMAHA | $5K | $1K | $6K | 18.95% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DR URBANDALE, IA 50323 | MUTUAL OF OMAHA | $0 | $2K | $2K | 5.00% |
| PROGRESSIVE BENEFIT GROUP3 | 9035 SOQUEL AVE SUITE 200 SANTA CRUZ, CA 95062 | MUTUAL OF OMAHA | $4K | $1K | $5K | 18.66% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DR URBANDALE, IA 50323 | MUTUAL OF OMAHA | $0 | $1K | $1K | 5.00% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 16835 W BERNARDO STE 212 SAN DIEGO, CA 92127 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $206 | $0 | $206 | 2.60% |
| PROGRESSIVE BENEFIT GROUP3 | 9035 SOQUEL AVE STE 200 SANTA CRUZ, CA 95062 | MUTUAL OF OMAHA | $699 | $0 | $699 | 15.01% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DR URBANDALE, IA 50323 | MUTUAL OF OMAHA | $0 | $233 | $233 | 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 | 243 | 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) | 243 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(7 contracts, 6 carriers) | SUTTER HEALTH PLUS | 293 | $2.9M |
| Dental | DELTA DENTAL | 208 | $257K |
| Vision | VISION SERVICE PLAN | 207 | $37K |
| Life insurance | MUTUAL OF OMAHA | 243 | $28K |
| Short-term disability(2 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 65 | $44K |
| Long-term disability | MUTUAL OF OMAHA | 241 | $33K |
| Prescription drug(2 contracts, 2 carriers) | SUTTER HEALTH PLUS | 293 | $2.7M |
| Other(3 contracts, 2 carriers) | MUTUAL OF OMAHA | 254 | $32K |
| 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."
No prospect flags tripped on this filing.