| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST INS. | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | KAISER FOUNDATION HEALTH PLAN, INC. | $48K | — | $48K | 5.01% |
| FILICE INSURANCE AGENCY3 | 900 E. HAMILTON AVE.#500 CAMPBELL, CA 95008 | KAISER FOUNDATION HEALTH PLAN, INC. | $16K | — | $16K | 1.68% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST INS. | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $680 | $4K | 5.23% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST INS. | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $149 | $6K | 11.23% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST INS. | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | VISION SERVICE PLAN | $938 | — | $938 | 6.14% |
| RYAN BEHM3 Filed as: RYAN PRESTON | 1150 MORAGA WAY MORAGA, CA 945561113 | LANDMARK HEALTH PLAN | $2K | — | $2K | 20.00% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST INS. | 3155 OLSEN DRIVE SAN JOSE, CA 95117 | SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION | $532 | $53 | $585 | 10.91% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MARIN BENEFITS ADMINISTRATORS EIN 83-2706943 NONE | Claims processing; Insurance brokerage commissions and fees; Plan Administrator; Insurance services; Contract Administrator; Insurance agents and brokers; Other services Service code 12 | 6366 COMMERCE BLVD. #293 ROHNERT PARK, CA 94928 | $56K |
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 | 174 | 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) | 174 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN, INC. | 174 | $957K |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 155 | $73K |
| Vision | VISION SERVICE PLAN | 90 | $15K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 128 | $51K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 128 | $51K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN, INC. | 174 | $957K |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 128 | $62K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 174 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.