| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | PO BOX 1788 GRAND RAPIDS, MI 49501 | UNITEDHEALTHCARE INSURANCE COMPANY | $102K | — | $102K | 3.67% |
| AMWINS3 Filed as: LISI LLC | 1600 W HILLSDALE BLVD, STE 201 SAN MATEO, CA 94402 | UNITEDHEALTHCARE INSURANCE COMPANY | $26K | — | $26K | 0.92% |
| ART YOUNG INSURANCE AGENCY3 | 415 CAMBRIDGE AVE PALO ALTO, CA 94306 | UNITEDHEALTHCARE INSURANCE COMPANY | $30 | — | $30 | 0.00% |
| AMWINS3 Filed as: LISI INSURANCE SERVICES INC | 1600 W HILLSDALE BLVD STE 201 SAN MATEO, CA 94402 | METROPOLITAN LIFE INSURANCE COMPANY | $18K | — | $18K | 4.97% |
| SUHR RISK SERVICES3 Filed as: SUHR ROBERT B & COMPANY INSURANCE | BROKERS INC 5300 STEVENS CREEK BLVD # 3FL SAN JOSE, CA 95129 | METROPOLITAN LIFE INSURANCE COMPANY | $10K | — | $10K | 2.77% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 910 E HAMILTON AVE STE 410 SOUTH TEXAS OILFIELD S, CA 95008 | KAISER FOUNDATION HEALTH PLAN INC | $14K | — | $14K | 4.56% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC DB | 910 E HAMILTON AVE STE 410 CAMPBELL, CA 95008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $1K | $4K | 14.02% |
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 | 394 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 397 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 402 | $3.1M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 1,472 | $362K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 1,472 | $362K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 388 | $31K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 388 | $31K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,472 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.