| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | PO BOX 1788 GRAND RAPIDS, MI 49501 | HEALTH NET | $59K | — | $59K | 4.82% |
| INTERNATIONAL PROINSURANCE SERVICES3 Filed as: INTERNATIONAL PROINSURANCE SVC, LLC | 3925 BOHANNON DR STE 100 MENLO PARK, CA 94025 | HEALTH NET | $144 | — | $144 | 0.01% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 5664 PRAIRIE CREEK DRIVE SE CALEDONIA, MI 49316 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $9K | $7K | $16K | 12.23% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 5664 PRAIRIE CREEK DR SE CALEDONIA, MI 49316 | KAISER FOUNDATION HEALTH PLAN INC | $5K | — | $5K | 4.19% |
| INTERNATIONAL PROINSURANCE SERVICES3 Filed as: INTERNATIONAL PROINSURANCE SVS LLC | 3925 BOHANNON DRIVE, SUITE 100 MENLO PARK, CA 94025 | KAISER FOUNDATION HEALTH PLAN INC | $475 | — | $475 | 0.38% |
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 | 104 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 104 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HEALTH NET | 147 | $1.3M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 104 | $134K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 104 | $134K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 104 | $134K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 104 | $134K |
| Prescription drug(2 contracts, 2 carriers) | HEALTH NET | 147 | $1.3M |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 104 | $134K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 147 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.