| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 | 2033 GATEWAY PL STE 150 SAN JOSE, CA 951103710 | KAISER FOUNDATION HEALTH PLAN INC | $31K | $35 | $31K | 3.64% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $15K | — | $15K | 2.68% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INS SVCS(CA) | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $6K | $6K | 1.13% |
| PATRICIA MARTINEZ3 | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY | -$133 | — | -$133 | -0.02% |
| DOMINIC CARRADERO3 | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY | -$399 | — | -$399 | -0.07% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 2033 GATEWAY PL STE 150 SAN JOSE, CA 951103710 | VISION SERVICE PLAN | $1K | — | $1K | 5.54% |
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 | 259 | 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) | 259 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 246 | $1.4M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 246 | $548K |
| Vision | VISION SERVICE PLAN | 184 | $20K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 246 | — |
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.