| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PROGRESSIVE BENEFIT GROUP3 | 9035 SOQUEL AVE STE 200 SANTA CRUZ, CA 950622033 | KAISER FOUNDATION HEALTH PLAN INC | $21K | $0 | $21K | 2.62% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST INSURA | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | KAISER FOUNDATION HEALTH PLAN INC | $2K | $1 | $2K | 0.22% |
| PBG PROFESSIONAL INSURANCE SERVICES3 | 9035 SOQUEL AVE STE 200 SANTA CRUZ, CA 950622033 | SUTTER HEALTH PLAN | $12K | $0 | $12K | 4.00% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3155 OLSEN DRIVE SAN JOSE, CA 95117 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | $1K | $8K | 7.48% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 9035 SOQUEL AVE STE 200 SANTA CRUZ, CA 95062 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $0 | $2K | 2.19% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 9035 SOQUEL AVE SUITE 200 SANTA CRUZ, CA 95062 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | $0 | $1K | 10.00% |
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 | 117 | 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) | 117 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 94 | $1.1M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 257 | $104K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 257 | $104K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 117 | $12K |
| Prescription drug | SUTTER HEALTH PLAN | 38 | $293K |
| Other | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 117 | $12K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 257 | — |
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.