| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 100 STONY POINT ROAD, SUITE 160 SANTA ROSA, CA 95401 | CALIFORNIA CHOICE | $31K | $0 | $31K | 3.36% |
| PGIS, INC.3 Filed as: PGIS HOLDINGS, LLC | UNKNOWN HEALDSBURG, CA 95445 | CALIFORNIA CHOICE | $15K | $0 | $15K | 1.62% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFIT GROUP, INC. | UNKNOWN HEALDSBURG, CA 95445 | CALIFORNIA CHOICE | $14K | $0 | $14K | 1.55% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 100 STONY POINT ROAD, SUITE 160 SANTA ROSA, CA 95401 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $881 | $5K | 7.27% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH | 1465 NORTH MCDOWELL BOULEVARD SUITE 180 PETALUMA, CA 94954 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 3.48% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 1950 WEST CORPORATE WAY ANAHEIM, CA 92801 | VISION SERVICE PLAN | $650 | $0 | $650 | 5.04% |
| PATRIOT GROWTH INSURANCE SERVICES3 | PO BOX 750004 PETALUMA, CA 94975 | VISION SERVICE PLAN | $428 | $0 | $428 | 3.32% |
| EMPLOYEE NAVIGATOR, LLC3 | 7979 OLD GEORGETOWN ROAD SUITE 300 BETHESDA, MD 20814 | VISION SERVICE PLAN | $27 | $0 | $27 | 0.21% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 100 STONY POINT ROAD, SUITE 160 SANTA ROSA, PA 95401 | PREMIER ACCESS INSURANCE COMPANY | $3K | $0 | $3K | 28.24% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWN INSURANCE SERVICES | 501 OFFICE CENTER DRIVE, SUITE 215 FORT WASHINGTON, PA 19034 | PREMIER ACCESS INSURANCE COMPANY | $975 | $0 | $975 | 9.26% |
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 | 126 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 126 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA CHOICE | 98 | $910K |
| Dental | PREMIER ACCESS INSURANCE COMPANY | 197 | $11K |
| Vision | VISION SERVICE PLAN | 103 | $13K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 126 | $70K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 126 | $70K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 126 | $70K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 126 | $70K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 197 | — |
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.