| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA | 5664 PRAIRIE CREEK DRIVE SE CALEDONIA, MI 49316 | KAISER FOUNDATION HEALTH PLAN INC | $28K | $0 | $28K | 4.88% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA | 601 UNIVERSITY AVENUE, SUITE 250 SACRAMENTO, CA 95825 | SUTTER HEALTH PLAN | $12K | $0 | $12K | 5.00% |
| JESSICA HINKLE3 | 601 UNIVERSITY AVENUE, SUITE 250 SACRAMENTO, CA 95825 | WESTERN HEALTH ADVANTAGE | $8K | $0 | $8K | 5.00% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA | 601 UNIVERSITY AVENUE, SUITE 250 SACRAMENTO, CA 95825 | PRINCIPAL LIFE INSURANCE COMPANY | $14K | $0 | $14K | 10.00% |
| UNKNOWN3 | UNKNOWN DIAMOND SPRINGS, CA 95619 | HEALTH AND HUMAN RESOURCE CENTER, INC. | $140 | $0 | $140 | 5.01% |
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 | 159 | 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) | 159 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 60 | $971K |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 171 | $142K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 171 | $142K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 171 | $142K |
| Prescription drug(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 60 | $971K |
| Other(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 171 | $145K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 171 | — |
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.