| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 910 E HAMILTON AVE STE 410 CAMPBELL, CA 95008 | KAISER FOUNDATION HEALTH PLAN INC | $206K | $14 | $206K | 1.85% |
| SUHR RISK SERVICES3 Filed as: SUHR RISK SERVICES OF CALIFORNIA | 910 E HAMILTON AVE STE 410 CAMPBELL, CA 95008 | SUTTER HEALTH PLAN | $63K | — | $63K | 5.00% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 910 E HAMILTON AVE STE 410 CAMPBELL, CA 95008 | DELTA DENTAL OF CALIFORNIA | $28K | — | $28K | 6.30% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 910 E HAMILTON AVE STE 410 CAMPBELL, CA 95008 | VISION SERVICE PLAN | $5K | — | $5K | 9.13% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC DBA | 910 E HAMILTON AVE, STE 410 CAMPBELL, CA 95008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $898 | $2K | 10.13% |
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 | 880 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 882 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 1,399 | $12.4M |
| Dental | DELTA DENTAL OF CALIFORNIA | 1,331 | $441K |
| Vision | VISION SERVICE PLAN | 300 | $60K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 944 | $20K |
| Prescription drug | SUTTER HEALTH PLAN | 191 | $1.3M |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 944 | $20K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,399 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.