| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA | 100 STONY POINT ROAD SUITE 160 SANTA ROSA, CA 95401 | CALIFORNIACHOICE | $43K | — | $43K | 4.99% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFIT GROUP | 11555 SORRENTO VALLEY ROAD SAN DIEGO, CA 92121 | CALIFORNIACHOICE | $13K | — | $13K | 1.55% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 100 STONY POINT RD STE 160 SANTA ROSA, CA 95401 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | $1K | $8K | 11.70% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA | 100 STONY POINT ROAD SUITE 160 SANTA ROSA, CA 95401 | CALIFORNIACHOICE | $1K | — | $1K | 5.00% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFIT GROUP | 11555 SORRENTO VALLEY ROAD SAN DIEGO, CA 92121 | CALIFORNIACHOICE | $610 | — | $610 | 2.66% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 100 STONY POINT RD STE 160 SANTA ROSA, CA 95401 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $362 | $3K | 18.88% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | DBA VANTREO INSURANCE BROKERAGE 100 STONY POINT ROAD SANTA ROSA, CA 95401 | PREMIER ACCESS INSURANCE COMPANY | $4K | — | $4K | 37.19% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 1950 W CORPORATE WAY ANAHEIM, CA 92801 | VISION SERVICE PLAN | $901 | — | $901 | 100.00% |
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 | 123 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | 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) | CALIFORNIACHOICE | 102 | $884K |
| Dental | PREMIER ACCESS INSURANCE COMPANY | 209 | $11K |
| Vision | VISION SERVICE PLAN | 104 | $901 |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 120 | $85K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 120 | $67K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 120 | $67K |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 120 | $85K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 209 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.