| 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 | $44K | $62 | $44K | 4.29% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $61K | — | $61K | 10.94% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INS SVCS(CA) | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $25K | $25K | 4.43% |
| ACRISURE LLC3 | 2033 GATEWAY PL STE 150 SAN JOSE, CA 95110 | AFLAC | $13K | — | $13K | 20.39% |
| NICHOLAS J PISANO JR3 | 15781 CANON DR LOS GATOS, CA 95030 | AFLAC | $7K | $1K | $8K | 13.40% |
| JAYSON C ROCHA3 | 3279 SOUTHERLAND RD WEST SACRAMENTO, CA 95691 | AFLAC | $5K | $1K | $6K | 9.42% |
| KAMALA J COBURN3 | 934 LONGWOOD LN SAN JOSE, CA 95129 | AFLAC | $3K | $300 | $3K | 4.68% |
| DERREK LYN KECK3 | 17809 COUNTRYSIDE CT SALINAS, CA 93907 | AFLAC | $636 | — | $636 | 1.01% |
| SLR INSURANCE SOLUTIONS INC3 Filed as: SLR INSURANCE SOLUTIONS | 3779 PEARL AVE SAN JOSE, CA 95136 | AFLAC | $124 | — | $124 | 0.20% |
| ACRISURE LLC3 Filed as: ACRISURE, LLC | 2033 GATEWAY PL STE 150 SAN JOSE, CA 951103710 | VISION SERVICE PLAN | $1K | — | $1K | 5.23% |
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 | 176 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 178 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 235 | $1.6M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 235 | $554K |
| Vision | VISION SERVICE PLAN | 187 | $20K |
| Life insurance | AFLAC | 72 | $63K |
| Short-term disability | AFLAC | 72 | $63K |
| Other(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 235 | $617K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 235 | — |
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.