| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 5664 PRAIRIE CREEK DR SE CALEDONIA, MI 49316 | KAISER FOUNDATION HEALTH PLAN INC | $119K | — | $119K | 4.38% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 910 E HAMILTON AVE, STE 410 CAMPBELL, CA 95008 | KAISER FOUNDATION HEALTH PLAN INC | $25K | — | $25K | 0.91% |
| PROCO INSURANCE SERVICES3 | 910 E HAMILTON AVE, STE 410 CAMPBELL, CA 95008 | SUTTER HEALTH PLAN | $15K | — | $15K | 5.00% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 910 E HAMILTON AVE CAMPELL, CA 95008 | DELTA DENTAL OF CALIFORNIA | $28K | — | $28K | 10.52% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 910 E HAMILTON AVE, STE 410 CAMPBELL, CA 95008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | $2K | $10K | 8.52% |
| ABD INS. AND FINANCIAL SVCS., INC.3 Filed as: ABD INSURANCE AND FINANCIAL SE | 777 MARINERS ISLAND BLVD STE 250 SAN MATEO, CA 94404 | UNUM LIFE INSURANCE COMPANY OF AMERICA | -$400 | — | -$400 | -0.33% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 910 E HAMILTON AVE, STE 410 CAMPBELL, CA 95008 | VISION SERVICE PLAN | $1K | — | $1K | 4.16% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC DB | 910 E HAMILTON AVE STE 410 CAMPBELL, CA 95008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $417 | $4K | 17.00% |
| ABD INS. AND FINANCIAL SVCS., INC.3 Filed as: ABD INSURANCE AND FINANCIAL SE | 777 MARINERS ISLAND BLVD STE 250 SAN MATEO, CA 94404 | UNUM LIFE INSURANCE COMPANY OF AMERICA | -$200 | — | -$200 | -0.96% |
| SYNERGY ENROLLMENT AND BENEFITS LLC3 Filed as: SYNERGY ENROLLMENT AND BENEFITS, LL | 9370 SKY PARK CT SUITE 250 SAN DIEGO, CA 92123 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $793 | — | $793 | 5.88% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | DBA PROCO INSURANCE SE 910 E HAMILTON AVE, STE 410 CAMPBELL, CA 95008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $339 | — | $339 | 2.51% |
| SYNERGY ENROLLMENT AND BENEFITS LLC3 Filed as: SYNERGY ENROLLMENT AND BENEFITS, LL | 9370 SKY PARK CT SUITE 250 SAN DIEGO, CA 92123 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $622 | $5 | $627 | 4.74% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | DBA PROCO INSURANCE SE 910 E HAMILTON AVE, STE 410 CAMPBELL, CA 95008 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $267 | $1 | $268 | 2.03% |
| MARIA GALICIA4 | 3601 NIGHTINGALE DR ANTIOCH, CA 94509 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $635 | — | $635 | 9.57% |
| SILVIO J. ESTRADA4 | 15 PLUMAS CT BAY POINT, CA 94565 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $63 | — | $63 | 0.95% |
| CORE FINANCIAL PARTNERS LLC4 | 364 E MAIN ST MIDDLETOWN, DE 19709 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $36 | — | $36 | 0.54% |
| PAMELA BRINKER4 | 72502 EDGEHILL DR UNIT 3 PALM DESERT, CA 92260 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $29 | — | $29 | 0.44% |
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 | 238 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 238 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 349 | $3.0M |
| Dental | DELTA DENTAL OF CALIFORNIA | 428 | $263K |
| Vision | VISION SERVICE PLAN | 195 | $34K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 238 | $141K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 38 | $13K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 238 | $120K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 349 | $3.0M |
| Other(5 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 238 | $174K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 428 | — |
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.