| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE WEST INSURANCE SERVICES LL | 900 EAST HAMILTON AVENUE SUITE 500 CAMPBELL, CA 95008 | ANTHEM BLUE CROSS | $53K | — | $53K | 3.70% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | ANTHEM BLUE CROSS | $5K | — | $5K | 0.36% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST INSURA | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | KAISER FOUNDATION HEALTH PLAN, INC. | $28K | — | $28K | 3.23% |
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE SERVICES, | 2677 N MAIN ST STE 800 SANTA ANA, CA 92705 | KAISER FOUNDATION HEALTH PLAN, INC. | $15K | — | $15K | 1.71% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 5664 PRAIRIE CREEK DR SE CALEDONIA, MI 49316 | KAISER FOUNDATION HEALTH PLAN, INC. | $9K | — | $9K | 1.06% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST | ATTN ACRISURE WEST COAST INSU 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $16K | $4K | $20K | 12.18% |
| GROUP BENEFITS LTD3 Filed as: GROUP BENEFITS, LTD | 12006 RIDGEMONT DR URBANDALE, IA 50323 | VISION SERVICE PLAN | $2K | — | $2K | 4.94% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 1950 W CORPORATE WAY, #33276 ANAHEIM, CA 92801 | VISION SERVICE PLAN | $1K | — | $1K | 2.40% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST | INSURANCE SERVICES, LLC 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | VISION SERVICE PLAN | $455 | — | $455 | 1.03% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST | INSURANCE SERVICES LLC 3155 OLSEN DR, SUITE 400 SAN JOSE, CA 95117 | SUN LIFE ASSURANCE COMPANY OF CANADA | $4K | — | $4K | 14.53% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DR URBANDALE, IA 50323 | SUN LIFE ASSURANCE COMPANY OF CANADA | $1K | — | $1K | 4.85% |
| ACRISURE LLC3 | 1460 US HIGHWAY 9 N SUITE 307 WOODBRIDGE, NJ 07095 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $211 | $211 | 0.76% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 1950 W CORPORATE WAY, #33276 ANAHEIM, CA 92801 | GUARDIAN | — | $313 | $313 | 3.36% |
| DAILYFEATS INC.3 | 131 TREMONT STREET 3RD FLOOR BOSTON, MA 02111 | GUARDIAN | $279 | — | $279 | 3.00% |
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 | 125 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 126 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | ANTHEM BLUE CROSS | 127 | $2.3M |
| Dental | GUARDIAN | 120 | $9K |
| Vision | VISION SERVICE PLAN | 120 | $44K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 127 | $164K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 127 | $164K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 127 | $164K |
| Other(4 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 127 | $205K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 127 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.