| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 910 E HAMILTON AVE 410 CAMPBELL, CA 95008 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $242K | — | $242K | 8.01% |
| AMWINS3 Filed as: LISI INSURANCE SERVICES INC | 1600 W HILLSDALE BLVD STE 201 SAN MATEO, CA 94402 | METROPOLITAN LIFE INSURANCE COMPANY | $16K | $923 | $17K | 4.80% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 910 E HAMILTON AVE STE 410 CAMPBELL, CA 95008 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | — | $3K | 0.76% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 9655 GRANITE RIDGE DR STE 500 SAN DIEGO, CA 92123 | METROPOLITAN LIFE INSURANCE COMPANY | — | $2K | $2K | 0.49% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 5664 PRAIRIE CREEK DR SE CALEDONIA, MI 49316 | KAISER FOUNDATION HEALTH PLAN INC | $16K | — | $16K | 4.89% |
| SYNERGY ENROLLMENT AND BENEFITS LLC3 Filed as: SYNERGY ENROLLMENT AND BENEFITS | 9370 SKY PARK CT SUITE 250 SAN DIEGO, CA 92123 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | $353 | $9K | 9.71% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | DBA PROCO INSURANCE SE 910 E HAMILTON AVE, STE 410 CAMPBELL, CA 95008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $105 | $4K | 4.11% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 910 E HAMILTON AVE STE 410 CAMPBELL, CA 95008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $11K | $1K | $12K | 17.00% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC DB | 910 E HAMILTON AVE STE 410 CAMPBELL, CA 95008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $749 | $6K | 16.98% |
| ACRISURE LLC4 Filed as: ACRISURE OF CALIFORNIA LLC | 5300 STEVENS CREEK BLVD FL 3 SAN JOSE, CA 95159 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $652 | — | $652 | 8.59% |
| MASOLI LEGACY LLC4 | 4319 BLENHEIM WAY CONCORD, CA 94521 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $433 | — | $433 | 5.70% |
| BETTY VEU4 | 1010 SW 42ND ST LAWTON, OK 73505 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $266 | — | $266 | 3.50% |
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 | 362 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 363 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 402 | $3.3M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 1,320 | $348K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 1,320 | $348K |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 1,320 | $385K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 81 | $73K |
| Other(4 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 1,320 | $482K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,320 | — |
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.