| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 5664 PRAIRIE CREEK DRIVE SE CALEDONIA, MI 49316 | KAISER FOUNDATION HEALTH PLAN INC | $17K | — | $17K | 3.09% |
| LYNNE WALLACE3 | 100 STONY POINT ROAD SUITE 160 SANTA ROSA, CA 95401 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $8K | — | $8K | 2.26% |
| TGG SOLUTIONS3 | 588 3 MILE ROAD NW STE 101 GRAND RAPIDS, MI 49544 | BLUE CROSS BLUE SHIELD OF MICHIGAN | $3K | — | $3K | 0.85% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC DBA | VANTREO INSURANCE BROKERAGE 100 STONY POINT ROAD, STE 160 SANTA ROSA, CA 95401 | PREMIER ACCESS INSURANCE COMPANY | $6K | — | $6K | 6.66% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 100 STONY POINT RD STE 160 SANTA ROSA, CA 95401 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $430 | $2K | 11.09% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC DB | A VANTREO INSURANCE BROKERAGE 100 STONY POINT RD STE 160 SANTA ROSA, CA 95401 | VISION SERVICE PLAN | $930 | — | $930 | 6.15% |
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 | 162 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 162 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 75 | $920K |
| Dental | PREMIER ACCESS INSURANCE COMPANY | 181 | $90K |
| Vision | VISION SERVICE PLAN | 158 | $15K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 151 | $21K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MICHIGAN | 74 | $360K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 151 | $21K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 181 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.