| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| VANTREO INSURANCE BROKERAGE3 | 100 STONY POINT ROAD SUITE 160 SANTA ROSA, CA 95401 | KAISER FOUNDATION HEALTH PLAN | $20K | — | $20K | 3.43% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 5664 PRAIRIE CREEK DRIVE SE CALEDONIA, MI 49316 | KAISER FOUNDATION HEALTH PLAN | $9K | — | $9K | 1.55% |
| VANTREO INSURANCE BROKERAGE3 | 100 STONY POINT RD SUITE 160 SANTA ROSA, CA 95401 | VISION SERVICE PLAN | $863 | — | $863 | 4.42% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC DBA VAN | 100 STONY POINT ROAD SANTA ROSA, CA 95401 | VISION SERVICE PLAN | $185 | — | $185 | 0.95% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 100 STONY POINT RD SUITE 160 SANTA ROSA, CA 95401 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $805 | — | $805 | 7.61% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 5664 PRAIRIE CREEK DRIVE SE CALEDONIA, MI 49316 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $663 | — | $663 | 6.27% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC DBA VAN | 100 STONY POINT ROAD SANTA ROSA, CA 95401 | PREMIER ACCESS INSURANCE COMPANY | $1K | — | $1K | 23.80% |
| VANTREO INSURANCE BROKERAGE3 | 100 STONY POINT ROAD SUITE 160 SANTA ROSA, CA 95401 | PREMIER ACCESS INSURANCE COMPANY | $267 | — | $267 | 4.97% |
| VANTREO INSURANCE BROKERAGE3 | 100 STONY POINT ROAD SUITE 100 SANTA ROSA, CA 95401 | PREMIER ACCESS INSURANCE COMPANY | $322 | — | $322 | 6.40% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC DBA VAN | 100 STONY POINT ROAD SANTA ROSA, CA 95401 | PREMIER ACCESS INSURANCE COMPANY | $178 | — | $178 | 3.54% |
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 | 117 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 117 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN | 115 | $590K |
| Dental(2 contracts) | PREMIER ACCESS INSURANCE COMPANY | 125 | $10K |
| Vision | VISION SERVICE PLAN | 98 | $20K |
| Life insurance | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 151 | $11K |
| Long-term disability | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 151 | $11K |
| Other | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 151 | $11K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 151 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.