| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CALIFORNIA PHYSICIANS SERVICE3 | 50 BEALE STREET SAN FRANCISCO, CA 94105 | BLUE SHIELD OF CALIFORNIA | $5K | — | $5K | 0.21% |
| ACRISURE LLC3 Filed as: DIBUDUO & DEFENDIS INSURANCE | 6873 N. WEST AVENUE, #101 FRESNO, CA 93711 | BLUE SHIELD OF CALIFORNIA | — | $87 | $87 | 0.00% |
| ACRISURE LLC3 Filed as: DIBUDUO & DEFENDIS AGENCY | 6873 N. WEST AVENUE, #101 FRESNO, CA 93711 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | $380 | $8K | 14.59% |
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 | 303 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 303 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | BLUE SHIELD OF CALIFORNIA | 624 | $2.9M |
| Dental | CALIFORNIA DENTAL NETWORK, INC. | 94 | $15K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 152 | $55K |
| Prescription drug | BLUE SHIELD OF CALIFORNIA | 624 | $2.3M |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 152 | $55K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 624 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.