| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE WEST INSURANCE SERVICES LL | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | KAISER FOUNDATION HEALTH PLAN | $17K | $1 | $17K | 1.75% |
| PROGRESSIVE BENEFIT GROUP3 | 9035 SOQUEL AVE SUITE 200 SANTA CRUZ, CA 95062 | KAISER FOUNDATION HEALTH PLAN | $12K | $0 | $12K | 1.22% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | PO BOX 1788 GRAND RAPIDS, MI 49501 | AETNA LIFE INSURANCE CO. | $41K | $0 | $41K | 5.01% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | PO BOX 1788 GRAND RAPIDS, MI 49501 | AETNA HEALTH, INC | $16K | $0 | $16K | 5.02% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 611 ANTON BLVD STE 1400 COSTA MESA, CA 92626 | METROPOLITAN LIFE INSURANCE COMPANY | $15K | $10 | $15K | 9.83% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DR URBANDALE, IA 50323 | METROPOLITAN LIFE INSURANCE COMPANY | $7K | $0 | $7K | 4.91% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST INSURA | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | VISION SERVICE PLAN | $1K | $0 | $1K | 6.52% |
| GROUP BENEFITS LTD3 Filed as: GROUP BENEFITS, LTD. | 12006 RIDGEMONT DR URBANDALE, IA 50323 | VISION SERVICE PLAN | $851 | $0 | $851 | 3.99% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 9035 SOQUEL AVE #200 SANTA CRUZ, CA 95062 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $391 | $0 | $391 | 5.67% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DR URBANDALE, IA 50323 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $345 | $345 | 5.00% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST INSURA | 3155 OLSEN DR STE 400 SAN JOSE, CA 95117 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $299 | $0 | $299 | 4.33% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 3 POLARIS WAY #4 ALISO VIEJO, CA 92656 | SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION | $202 | $0 | $202 | 10.08% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DR URBANDALE, IA 50323 | SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION | $101 | $0 | $101 | 5.04% |
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 | 210 | 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) | 210 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN | 104 | $2.1M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 384 | $151K |
| Vision | VISION SERVICE PLAN | 146 | $21K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 210 | $7K |
| Other | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 210 | $7K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 384 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.