| 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 | $91K | — | $91K | 4.55% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 910 E HAMILTON AVE, STE 410 CAMPBELL, CA 95008 | KAISER FOUNDATION HEALTH PLAN INC | $8K | — | $8K | 0.41% |
| ACRISURE LLC3 Filed as: ACRISURE OF CA, LLC DBA PROCO | INSURANCE SERVICES 5300 STEVENS CREEK BLVD, FLOOR #3 SAN JOSE, CA 95129 | PREMIER ACCESS INSURANCE COMPANY | $5K | — | $5K | 2.23% |
| PROCO INSURANCE SERVICES3 | 910 E HAMILTON AVE STE 410 CAMPBELL, CA 95008 | SUTTER HEALTH PLAN | $9K | — | $9K | 5.00% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 910 E HAMILTON AVE SUITE 140 CAMPBELL, CA 95008 | SUN LIFE ASSURANCE COMPANY OF CANADA | $7K | — | $7K | 10.34% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DR URBANDALE, IA 50323 | SUN LIFE ASSURANCE COMPANY OF CANADA | $2K | — | $2K | 3.24% |
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 | 317 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 317 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 298 | $2.2M |
| Dental | PREMIER ACCESS INSURANCE COMPANY | 359 | $228K |
| Vision | SUN LIFE ASSURANCE COMPANY OF CANADA | 305 | $64K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 305 | $64K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 305 | $64K |
| Prescription drug | SUTTER HEALTH PLAN | 28 | $179K |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 305 | $64K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 359 | — |
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."
No prospect flags tripped on this filing.