| 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 | $146K | — | $146K | 4.75% |
| PROCO INSURANCE SERVICES3 | 910 E HAMILTON AVE, STE 410 CAMPBELL, CA 95008 | SUTTER HEALTH PLAN | $27K | — | $27K | 5.00% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 910 E HAMILTON AVE CAMPELL, CA 95008 | DELTA DENTAL OF CALIFORNIA | $28K | — | $28K | 10.00% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 910 E HAMILTON AVE, STE 410 CAMPBELL, CA 95008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | $2K | $9K | 8.46% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 910 E HAMILTON AVE, STE 410 CAMPBELL, CA 95008 | VISION SERVICE PLAN | $2K | — | $2K | 4.41% |
| 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 | $453 | $4K | 17.00% |
| 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 | $722 | — | $722 | 4.56% |
| 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 | $310 | — | $310 | 1.96% |
| SYNERGY ENROLLMENT AND BENEFITS LLC3 Filed as: SYNERGY ENROLLMENT AND BENEFITS, LL | 3550 CAMINO DEL RIO N STE 207 SAN DIEGO, CA 92108 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $469 | — | $469 | 3.24% |
| 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 | $202 | — | $202 | 1.39% |
| MARIA GALICIA4 | 3601 NIGHTINGALE DR ANTIOCH, CA 94509 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $691 | — | $691 | 10.46% |
| SILVIO J. ESTRADA4 | 15 PLUMAS CT BAY POINT, CA 94565 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $69 | — | $69 | 1.04% |
| CORE FINANCIAL PARTNERS LLC4 | 364 E MAIN ST MIDDLETOWN, DE 19709 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $29 | — | $29 | 0.44% |
| PAMELA BRINKER4 | 72502 EDGEHILL DR UNIT 3 PALM DESERT, CA 92260 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $26 | — | $26 | 0.39% |
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 | 244 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 244 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 334 | $3.6M |
| Dental | DELTA DENTAL OF CALIFORNIA | 434 | $276K |
| Vision | VISION SERVICE PLAN | 202 | $34K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 244 | $133K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 33 | $14K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 244 | $110K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 334 | $3.6M |
| Other(5 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 244 | $166K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 434 | — |
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.