| 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. | $39K | — | $39K | 5.05% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3925 BOHANNON DR STE 100 MENLO PARK, CA 94025 | CALIFORNIA PHYSICIANS' SERVICE | $22K | — | $22K | 3.66% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST INSURA | SERVICES, LLC 3155 OLSEN DRIVE SAN JOSE, CA 95117 | CALIFORNIA PHYSICIANS' SERVICE | $8K | — | $8K | 1.34% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3 POLARIS WAY 4TH FLOOR ALISO VIEJO, CA 92656 | GUARDIAN | $5K | $526 | $6K | 26.79% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 9140 E HAMILTON AVE #410 CAMPBELL, CA 95008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 20.00% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 9140 E HAMILTON AVE #410 CAMPBELL, CA 95008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $262 | $2K | 17.95% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 9140 E HAMILTON AVE #410 CAMPBELL, CA 95008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $842 | — | $842 | 10.00% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 9140 E HAMILTON AVE #410 CAMPBELL, CA 95008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $268 | $2K | 18.24% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 9140 E HAMILTON AVE #410 CAMPBELL, CA 95008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $814 | — | $814 | 10.00% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 9140 E HAMILTON AVE #410 CAMPBELL, CA 95008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $301 | $1K | 18.83% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 9140 E HAMILTON AVE #410 CAMPBELL, CA 95008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $990 | $186 | $1K | 17.82% |
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 | 122 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 124 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 99 | $1.4M |
| Dental | GUARDIAN | 118 | $21K |
| Vision | GUARDIAN | 118 | $21K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 122 | $15K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 46 | $9K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 44 | $8K |
| Prescription drug | CALIFORNIA PHYSICIANS' SERVICE | 65 | $606K |
| Other(5 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 122 | $43K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 122 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.