| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 910 E. HAMILTON AVE. SUITE 410 CAMPBELL, CA 95008 | KAISER FOUNDATION HEALTH PLAN INC | $18K | $2 | $18K | 4.63% |
| ROBERT B. SUHR & COMPANY INSURANCE3 Filed as: ROBERT B SUHR & COMPANY INS | 910 E. HAMILTON AVE., SUITE 410 CAMPBELL, CA 95008 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $10K | — | $10K | 3.99% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 5664 PRAIRIE CREEK DR. SE CALEDONIA, MI 49316 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $7K | — | $7K | 3.01% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INS SVCS | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 91316 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $7K | $7K | 2.80% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INS SVCS (CA) | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 91361 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $4K | $4K | 3.94% |
| ROBERT B. SUHR & COMPANY3 Filed as: ROBERT B SUHR & COMPANY INS BROKERS | 910 E. HAMILTON AVE. SUITE 410 CAMPBELL, CA 95008 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $388 | — | $388 | 0.42% |
| SUHR RISK SERVICES3 Filed as: SUHR RISK INS SERVICES OF CA | ACRISURE CO 910 E HAMILTON AVE., STE 410 CAMPBELL, CA 95008 | UNION SECURITY INSURANCE COMPANY | $2K | — | $2K | 15.21% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 5300 STEVENS CREEK BLVD STE 300 SAN JOSE, CA 95129 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 15.00% |
| ACRISURE LLC3 | 910 E. HAMILTON AVE., SUITE 410 CAMPBELL, CA 95008 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $748 | — | $748 | 14.99% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 910 E. HAMILTON AVE. SUITE 410 CAMPBELL, CA 95008 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $685 | — | $685 | 15.01% |
| SUHR RISK SERVICES3 Filed as: SUHR RISK INS SERVICES OF CA | ACRISURE CO 910 E HAMILTON AVE, STE 410 CAMPBELL, CA 95008 | UNION SECURITY INSURANCE COMPANY | $599 | — | $599 | 24.04% |
| SUHR RISK SERVICES3 Filed as: SUHR RISK INS SERVICES OF CA | ACRISURE CO 910 E HAMILTON AVE., STE 410 CAMPBELL, CA 95008 | UNION SECURITY INSURANCE COMPANY | $351 | — | $351 | 25.92% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 910 E. HAMILTON AVE. SUITE 410 CAMPBELL, CA 95008 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $173 | — | $173 | 15.03% |
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 | 107 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 107 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 51 | $631K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 95 | $92K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 95 | $92K |
| Life insurance(3 contracts, 3 carriers) | UNION SECURITY INSURANCE COMPANY | 107 | $18K |
| Short-term disability(3 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 107 | $9K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 107 | $11K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 43 | $390K |
| Other(3 contracts, 3 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 107 | $4K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 107 | — |
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.