| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 5664 PRAIRIE CREEK DR SE CALEDONIA, MI 49316 | KAISER FOUNDATION HEALTH PLAN, INC | $136K | — | $136K | 4.99% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 910 E HAMILTON AVE STE 410 CAMPBELL, CA 95008 | METROPOLITAIN LIFE INSURANCE COMPANY | $36K | — | $36K | 7.72% |
| PLANSOURCE BENEFITS ADMINISTRATION3 | 101 S GARLAND AVE, STE 203 ORLANDO, FL 32801 | METROPOLITAIN LIFE INSURANCE COMPANY | $705 | $4K | $5K | 1.04% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | METROPOLITAIN LIFE INSURANCE COMPANY | $4K | — | $4K | 0.96% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 9655 GRANITE RIDGE DR STE 500 SAN DIEGO, CA 92123 | METROPOLITAIN LIFE INSURANCE COMPANY | — | $4K | $4K | 0.95% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 100 OTTAWA AVENUE SW GRAND RAPIDS, MI 49503 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $9K | — | $9K | 4.81% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $83 | $83 | 0.04% |
| BALTOR INSURANCE SERVICES3 | 11 AIRPORT BLVD SUITE 105 SOUTH SAN FRANCISCO, CA 94080 | CONTINENTAL AMERICAN INSURANCE COMPANY | $3K | — | $3K | 6.42% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 100 OTTAWA AVENUE SW GRAND RAPIDS, MI 49503 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | — | $2K | 6.03% |
| JOSHUA BALTOR3 Filed as: JOSHUA S BALTOR | 533 AIRPORT BLVD STE 400 SUITE 105 BURLINGAME, CA 94010 | CONTINENTAL AMERICAN INSURANCE COMPANY | $681 | — | $681 | 1.72% |
| RUBEN ROSA3 | 933 LEE RD 200 ORLANDO, FL 32810 | CONTINENTAL AMERICAN INSURANCE COMPANY | $419 | — | $419 | 1.06% |
| CHRIS KELLY3 | 252 WIKIUP MEADOWS DR SANTA ROSA, CA 95403 | CONTINENTAL AMERICAN INSURANCE COMPANY | $340 | — | $340 | 0.86% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 16835 W BERNARDO STE 212 SAN DIEGO, CA 92127 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $775 | — | $775 | 2.60% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 100 OTTAWA AVENUE SW GRAND RAPIDS, MI 49503 | SAFEGUARD HELATH PLANS, INC A CALIFORNIA CORPORATION | $771 | — | $771 | 8.90% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 9655 GRANITE RIDGE DR STE 500 SAN DIEGO, CA 92123 | SAFEGUARD HELATH PLANS, INC A CALIFORNIA CORPORATION | — | $98 | $98 | 1.13% |
| PLANSOURCE BENEFITS ADMINISTRATION3 | 101 S GARLAND AVE STE 203 ORLANDO, FL 32801 | SAFEGUARD HELATH PLANS, INC A CALIFORNIA CORPORATION | — | $77 | $77 | 0.89% |
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 | 381 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 10 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 391 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC | 338 | $2.7M |
| Dental(2 contracts, 2 carriers) | METROPOLITAIN LIFE INSURANCE COMPANY | 664 | $472K |
| Vision | METROPOLITAIN LIFE INSURANCE COMPANY | 664 | $463K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 381 | $198K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 381 | $198K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC | 338 | $2.7M |
| Other(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 381 | $237K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 664 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.