| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $189K | — | $189K | 4.91% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 5664 PRAIRIE CREEK DR SE CALEDONIA, MI 49316 | KAISER FOUNDATION HEALTH PLAN INC | $21K | — | $21K | 4.53% |
| AMWINS3 Filed as: LISI LLC DBA AMWINS CONNECT | INSURANCE SERVICES LLC 2677 N MAIN ST STE 800 SANTA ANA, CA 92705 | METROPOLITAN LIFE INSURANCE COMPANY | $16K | $891 | $17K | 4.37% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 910 E HAMILTON AVE STE 410 CAMPBELL, CA 95008 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | — | $3K | 0.90% |
| SUHR RISK SERVICES3 Filed as: SUHR ROBERT B & COMPANY INSURANCE | BROKERS INC 910 E HAMILTON AVE STE 410 CAMPBELL, CA 95008 | METROPOLITAN LIFE INSURANCE COMPANY | $912 | — | $912 | 0.24% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | DBA PROCO INSURANCE SERVICES 1950 W CORPORATE WAY ANAHEIM, CA 92801 | METROPOLITAN LIFE INSURANCE COMPANY | $811 | — | $811 | 0.21% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 9655 GRANITE RIDGE DR STE 500 SAN DIEGO, CA 92123 | METROPOLITAN LIFE INSURANCE COMPANY | — | $314 | $314 | 0.08% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC DB | 910 E HAMILTON AVE STE 410 CAMPBELL, CA 95008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $9K | $1K | $11K | 17.00% |
| SYNERGY ENROLLMENT AND BENEFITS LLC3 | 3550 CAMINO DEL RIO N STE 207 SAN DIEGO, CA 92108 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $19 | $3K | 5.03% |
| 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 | $1K | $7 | $1K | 2.16% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC DB | 910 E HAMILTON AVE STE 410 CAMPBELL, CA 95008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $648 | $6K | 17.00% |
| 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 | $376 | — | $376 | 5.05% |
| MASOLI LEGACY LLC4 | 4319 BLENHEIM WAY CONCORD, CA 94521 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $235 | — | $235 | 3.15% |
| BETTY VEU4 | 1010 SW 42ND ST LAWTON, OK 73505 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $157 | — | $157 | 2.11% |
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 | 386 | $4.3M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 1,335 | $386K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 1,335 | $386K |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 1,335 | $418K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 62 | $63K |
| Other(4 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 1,335 | $481K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,335 | — |
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.