| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 1615 MURRAY CANYON RD STE 1050 SAN DIEGO, CA 92108 | BLUE CROSS BLUE SHIELD OF CALIFORNIA | $52K | — | $52K | 4.15% |
| ACRISURE LLC3 Filed as: ACRISURE SW PARTNERS INS SVCS LLC | 611 ANTON BLVD STE 1400 COSTA MESA, CA 92626 | BLUE CROSS BLUE SHIELD OF CALIFORNIA | $11K | — | $11K | 0.85% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | KAISER FOUNDATION HEALTH PLAN INC | $17K | — | $17K | 2.74% |
| ACRISURE LLC3 Filed as: ACRISURE SW PARTNERS INS SVCS LLC | 611 ANTON BLVD STE 1400 COSTA MESA, CA 92626 | KAISER FOUNDATION HEALTH PLAN INC | $8K | — | $8K | 1.29% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | DBA AHERN INSURANCE BROKERAGE 1615 MURRAY CANYON RD STE 1050 SAN DIEGO, CA 92108 | METROPOLITAN LIFE INSURANCE COMPANY | $17K | $10 | $17K | 8.77% |
| ACRISURE LLC3 Filed as: ACRISURE SW PARTNERS INS SVCS LLC | 611 ANTON BLVD STE 1400 COSTA MESA, CA 92626 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $329 | $4K | 2.12% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST | INSURANCE SERVICES LLC 3155 OLSEN DR STE 400 SAN JOSE, CA 95117 | SUN LIFE ASSURANCE COMPANY OF CANADA | $5K | — | $5K | 8.12% |
| ACRISURE LLC3 | 1460 US HIGHWAY 9 N STE 307 WOODBRIDGE, NJ 07095 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $608 | $608 | 1.07% |
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 | 108 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 109 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF CALIFORNIA | 99 | $1.9M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 182 | $198K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 182 | $198K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 108 | $57K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 182 | $198K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF CALIFORNIA | 99 | $1.2M |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 108 | $57K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 182 | — |
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.