| 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 | $34K | — | $34K | 5.04% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC DBA | PROCO INSURANCE SERVICES 3925 BOHANNON DRIVE #100 MENLO PARK, CA 94025 | WESTERN HEALTH ADVANTAGE | $15K | — | $15K | 7.00% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | PO BOX 1788 GRAND RAPIDS, MI 49501 | UNITEDHEALTHCARE INSURANCE COMPANY | $8K | — | $8K | 7.00% |
| BEERE & PURVES INC3 | 1350 TREAT BLVD STE 470 WALNUT CREEK, CA 94597 | UNITEDHEALTHCARE INSURANCE COMPANY | $4K | — | $4K | 3.50% |
| INTERNATIONAL PROINSURANCE SERVICES3 Filed as: INTERNATIONAL PROINSURANCE SERV LLC | 3925 BOHANNON DR., STE 100 MENLO PARK, CA 94025 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $7K | — | $7K | 9.92% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 2055 WOODSIDE RD, STE 290 REDWOOD CITY, CA 94061 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $88 | $2K | 10.65% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 2055 WOODSIDE RD STE 290 REDWOOD CITY, CA 94061 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $414 | $4K | 17.97% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | PO BOX 1788 GRAND RAPIDS, MI 49501 | UNITEDHEALTHCARE OF CALIFORNIA | $1K | $643 | $2K | 10.50% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 2055 WOODSIDE RD STE 290 REDWOOD CITY, CA 94061 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $285 | $3K | 19.76% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3925 BOHANNON DR, STE 100 MENLO PARK, CA 94025 | CIGNA DENTAL HEALTH OF CALIFORNIA, INC. | $398 | — | $398 | 4.12% |
| INTERNATIONAL PROINSURANCE SERVICES3 Filed as: INTERNATIONAL PROINSURANCE SERV LLC | 3925 BOHANNON DR., STE 100 MENLO PARK, CA 94025 | CIGNA DENTAL HEALTH OF CALIFORNIA, INC. | $318 | — | $318 | 3.30% |
| ACRISURE LLC3 | 3925 BOHANNON DR. STE 100 MENLO PARK, CA 94025 | CIGNA DENTAL HEALTH OF CALIFORNIA, INC. | $250 | — | $250 | 2.59% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3925 BOHANNON DR, STE 100 MENLO PARK, CA 94025 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | $46 | $1K | — |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | DBA AHERN INSURANCE BROKERAGE 9655 GRANITE RIDGE DR SAN DIEGO, CA 92123 | METROPOLITAN LIFE INSURANCE COMPANY | — | $132 | $132 | — |
| INTERNATIONAL PROINSURANCE SERVICES3 | 3925 BOHANNON DR STE 100 MENLO PARK, CA 94025 | METROPOLITAN LIFE INSURANCE COMPANY | — | $30 | $30 | — |
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 | 128 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 128 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 128 | $1.0M |
| Dental(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 116 | $80K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 0 | $0 |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 77 | $21K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 51 | $13K |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 111 | $43K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 128 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.