| 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 | $223K | — | $223K | 2.08% |
| PROCO INSURANCE SERVICES3 | 910 E HAMILTON AVE STE 410 CAMPBELL, CA 95008 | SUTTER HEALTH PLAN | $59K | — | $59K | 4.99% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 910 E HAMILTON AVE STE 410 CAMPBELL, CA 95008 | VISION SERVICE PLAN | $8K | — | $8K | 10.01% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 910 E HAMILTON AVE STE 410 CAMPBELL, CA 95008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $12K | $2K | $13K | 18.18% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 910 E HAMILTON AVE STE 410 CAMPBELL, CA 95008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $859 | $5K | 12.60% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 910 E HAMILTON AVE CAMPBELL, CA 95008 | DELTA DENTAL OF CALIFORNIA | $3K | — | $3K | 10.00% |
| 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 | $467 | $2K | 8.57% |
| SYNERGY ENROLLMENT AND BENEFITS LLC3 | 9370 SKY PARK CT SUITE 250 SAN DIEGO, CA 92123 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $9 | $1K | 5.53% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | DBA PROCO INSURANCE SE 910 E HAMILTON AVE, STE 410 CAMPBELL, CA 95008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $429 | $2 | $431 | 2.36% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 910 E HAMILTON AVE STE 410 CAMPBELL, CA 95008 | DELTA DENTAL OF CALIFORNIA | $30K | — | $30K | — |
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 | 1,009 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 1,009 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 1,383 | $11.9M |
| Dental(2 contracts) | DELTA DENTAL OF CALIFORNIA | 1,403 | $33K |
| Vision | VISION SERVICE PLAN | 420 | $84K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,000 | $95K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 60 | $41K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 60 | $41K |
| Prescription drug | SUTTER HEALTH PLAN | 181 | $1.2M |
| Other(3 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,000 | $113K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,403 | — |
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.