| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | AETNA HEALTH, INC. | $21K | $0 | $21K | 2.53% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST | 3155 OLSEN DRIVE SAN JOSE, CA 95117 | AETNA HEALTH, INC. | $17K | $0 | $17K | 2.09% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC DBA PROG | 3 POLARIS WAY # 4 ALISO VIEJO, CA 926565338 | METROPOLITAN LIFE INSURANCE COMPANY | $24K | $0 | $24K | 8.70% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DR URBANDALE, IA 503232317 | METROPOLITAN LIFE INSURANCE COMPANY | $12K | $0 | $12K | 4.60% |
| GROUP BENEFITS LTD3 Filed as: GROUP BENEFITS, LTD. | 12006 RIDGEMONT DR URBANDALE, CA 503232317 | VISION SERVICE PLAN | $1K | $0 | $1K | 5.75% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC DBA PBG | 9035 SOQUEL AVE STE 200 SANTA CRUZ, CA 950622033 | VISION SERVICE PLAN | $1K | $0 | $1K | 5.44% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST INSURA | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | VISION SERVICE PLAN | $79 | $0 | $79 | 0.40% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3 POLARIS WAY # 4 ALISO VIEJO, CA 926565338 | SAFEGUARD HEALTH PLANS, INC | $282 | $0 | $282 | 7.35% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DR URBANDALE, IA 503232317 | SAFEGUARD HEALTH PLANS, INC | $176 | $0 | $176 | 4.59% |
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 | 378 | 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) | 378 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 378 | $274K |
| Vision | VISION SERVICE PLAN | 152 | $20K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 378 | $270K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 378 | $270K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 378 | $270K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 378 | $270K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 378 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.